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1981, 10-13 Permit: 81B-0610 Conversion BurnerPLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT' NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3•COPIES JOB ADDRESS LOT � ? no>3 }M Al 1\1 B z O K SUBDT ISION 2. ;LEGAL DESCRIPTION - SEE ATTACHED OWNER ��//��� � `l� 3 ort � 1� 1a ADDRESS M' CONT RACrR 041 r ADDRESS � sct 3 ahs AL PARCEL NUMBER/S etIONE reCo —c ZIP Actual Set Backs In Feet North 'South East (West PH�Size of Parcel Zone Classification (5 ZIP Type Const. Occupancy Sprinklered Oyes DNo 0 Req'd. 5. DESIGNER PHONE Valuation • (Building Area In Sq. Ft. ADDRESS ZIP Main Floor Upper Floors 1 Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK tit( TO Area of Decks Finished Basement Unf in. Basement ❑ NEW L'TA LT. �0 ADADN. 0 RPL. 0 MVE. 0 BLD. 0 PLMB -CJ MECH. 0 M.H. 0 POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings DESCRIBE WOR) s. ,_j�,(S � � C' revs tOki P e1 VALUATION SOURCE OF GAS ELECTRIC jv 9. UTILITIES J _Public O Private 0 CERTIFICATE of EXEMPTION Enum. Dist. Req'd. Recd. Not Req'd. Location (Area) WATER SEWER 'Ownership USE CODE 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 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 INSPECTIO DATE OF APPLICATION 9 k SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Bu ingThnician SPECIAL CONDITIONS: /00 wt 'r 20'-,y PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 1�v.CJa PERMIT NUMBER i31T3 - OCcIo 04* *1800 *1800 to - *18006 A *GOO -60.92 10-13-81 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. '11 to 31In'811' PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED 6L02 *18.00aie. - •PERMIT k10. TOTAL