1982, 10-25 Permit: 82B-0079 FireplaceNUMBER 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
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK B l0 PARCEL NUMBER/S
2.
OWNER PHONE
3.
ADDRESS
ZIP
Actual Set Backs in Feet
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.
TYPENEW ❑ ALT. ❑ AD 'N. 11 RPL. El MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. �C MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8.;n._
VALUATIO SOU CE
GAS
ELECTRIC ATER
SEWER
Ownership
USE CODE
OF
9. UTILITIES
Public ❑Private ❑
Single $
1 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
DATE OF APPLICATIONQ "y�-v_�r �
Mech.
—AQ SIGNATURE OF APPLICANT t5L
0212-1-111111
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
rianning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
9T
ch ici n
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ p�
PER��MIT NUMBER
�Y✓� / 5 �r'7 6C�
0C1* *2000
*2C 00"
A * n
7�
10-2v-82
6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-X25-82 7.923
*20.00 �