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1982, 12-29 Permit: 82B-2301 Fireplace, PipingPLAN NUMBER APPL ICAT ION /PERMIT SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 WORK APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES Received Yes ❑ No ❑ STREET ADDRESS Shorelines/ Flood Hazard Plans Required ❑ PARCEL NO. yes Not Applic. ❑ 1. 5, A-eAC\ SOW u�A L' GAS ELECTRIC WATER PUBLIC ❑ LOT BLOCK SUBDIVISION FEES COLLECTED 9 LEGAL DESCRIPTION: 2. PRIVATE ❑ EWER 1-1 I 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 Building OWNER �islT22 PHONE thority to violate or cancel the provisions of any other state or local law regulating construction or the performance PHONE Q� ©70t of construction. SEE REVERSZWDDFOR R QUI D MSPEATIONS Plumbing 3. W OWNER OR AGENT DATE 27 Mech. SPECIAL APPROVALS S ECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) MAILINGADDRESS PRELIM. FINAL DATE Zlpua t Backs n eetto: . � 1 `dam �Jt 7 its ( C;—,. �� �7 North South East West Planning CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 4. 6 6 rvs QOpt t+✓ T`s 5P—_4e+ - Oc�Z .� Commercial ❑ ADDRESS ZIP Type Const. Occupancy Sprtnklered 1r SCA i0❑Yes ❑No ❑Req'd. DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area 5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement 6. TYPE No. Baths No. Floors No. Fin. Rooms No. Dwellings . ❑ 9D' N. MINEW 0 ALT7• OF ❑ RPL. ❑ MVE. ❑ OTHER ❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL Certtfi of Exempt. Required Yes❑ No❑ Number WORK or Variance Received Yes ❑ No ❑ DESCRIBE WORK Shorelines/ Flood Hazard Plans Required ❑ 8• c_�, -P- A) U yes Not Applic. ❑ Received ❑ VALUATION SOURCE OF GAS ELECTRIC WATER PUBLIC ❑ [JS�EWAGE IC ❑public Ownership FEES COLLECTED 9 I PRIVATE ❑ EWER 1-1 ❑Private ❑UTILITIES 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 Building work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- thority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. SEE REVERSZWDDFOR R QUI D MSPEATIONS Plumbing SIGNATURE OF APPLICATION �� OWNER OR AGENT DATE 27 Mech. SPECIAL APPROVALS S ECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) Plan Check PRELIM. FINAL DATE Env. Health SEPA Modular/ Planning MFG.Home Utilities Plans I i i I PERMIT IS NONTRANSFERABLE Exam. I PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building .� t -a /� IN 180 DAYS Other (Specify) PERMIT NUMBER TOTAL $ 1--2-- 0::�) I WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE I,g,S&D2 9 82 PERMIT NO� 0. 1 z *1200°) TOTAL c i C L L