1982, 11-03 Permit: 82B-0520 DamperPLAN 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 B 6K • VISION
tr ' 'LEGAL DESCRIPTION,— SEE ATTACHED
PARCEL NUMBER/S
3.
OWNER
C. STEPHENS
ADpRESs E.. NORA SPOKANE
PHONE
928-4306
ZIP
Actual Set Backs in Feet
North 'South (East 'West
CONTRACTOR
DAVID VAN DORT
4, -6/6-EDM
DD ESS ##9g
0/0 EDM E9.514 MONTGOMER SPOKANE
DESIGNER
5.
PHONE
924-3986
Size of Parcel 1 Zone Classification
ZIP
99206
Type Const.
Occupancy
Sprinklered
DYes ONo 0 Req'd.
PHONE
Valuation }Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Oecks
Finished Basement -
Unfln. Basement
TYPE
7. OF
WORK
EINEW 0 ALT. 0 AD N. 0 RPL, 0 MVE,
0 BLD. 0 PLMB, ECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories ,
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. INSPECT SAVE FUEL DAMPER
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
X
Enum. Dist.
Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public O Private 0
' 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 INSPECTIONS
DATE OF APPLICATION 11. 2 ' 8 2 SIGNATURE OF APPLICANT 1U
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
$ 14 00
SEPA
Mobile Home
Other (Specify) -
14.00
TOTAL $
PERMIT NUMBER
04* *14.00
*14.008
A *Q00,
51,92
'11-03-82
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1114_A 3.:-.-'812 55 rt n
DATE ISSUED PERMIT Nb,� O 2 .* 14 V0.T6Lh,