1981, 10-29 Permit: 81B-1273 Fireplace InsertPLAN NUMBER APPLICATION/ PERMIT
^� PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT l' I 81 �- 12-7 3
/ NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
�. N. ` 09' H A N LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
OWNER
PHONE
3.0 f --9: L . µ tit,' K i 5
c7 ? — 0`7 55 -
ADDRESS
ZIP
Actual Set Backs in Feet
1
N `�0F JOHN �
n�
CM ZO(I
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
-]Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
TYPE 9-1qEW 1:1 ALT. El AD'N. El RPL. 1:1 MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7. OF ❑ OTHER
❑ BLD. ❑ PLMB. CYMECH. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd. Rec'd. Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
8. wocP PI+2 Pilkc - INs�T
FEES COL L ECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
Public ❑ Private ❑
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
7
DATE OF APPLICATION yL/ SIGNATURE OF APPLICAN
Mech. XIV
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Co. Engineer
Utilities
ns Examiner
Building Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
04* *17,00
*17.00
* 1 7,000
A *a00
1 27.22
10-29-81
2 6,479.
Mobile Home
% S i✓t£ cn_
Other (Specify) O KK
6V
TOTAL $ 7
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
b ;=12 8 1 12'
DATE ISSUED PERMIT NO.
*17,90a► -
TOTAL