1981, 12-03 Permit: 81B-2388 FireplacePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
L NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
St 5-:2:388
;Z3&$
`_�
APPLICANT: COMPLETE NUMBERED SPACES — PRESS'
HARD TO MAKE 3 COPIES
VALUATION
SOU CE
GAS
ADDRESS
WATER
0 * * 1 7.00
JOB ADDRESS
Main Floor
Upper Floors I
Garage Area
OF
UTILITIES
LEGAL DESCRIPTION —SEE ATTACHED
TO
Area of Decks
Finished Basement
* 1 7, G co
LOT
BLOCK
S
PARCEL NUMBER/S
2.
I
TYPE ❑NEW 1:1 ALT.
1:1AD'N. El RPL.
ElMVE.
No. Baths
OWNER
Q
PHONE
3. ,
7, OF/
ElBLD. ElEr PLMB.
,,�� -S`8 I
11OTHER
11POOL
G 3 7
ADDRESS
ZIP
Actual Set Backs in Feet
CERTIFICATE
l
Recd.
North South East West
1 c
ONTRA TOR
PHONE
Size of Parcel
Zone Classification
ESCRIBE WORK
1-2
�
Enum Dist Location (Area)
f 6,4 7 9.
ADDRESS % /%
ZIP
�9a0 %
Type Const.
Occupancy
1
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
VALUATION
SOU CE
GAS
ADDRESS
WATER
SEWER
ZIP
Main Floor
Upper Floors I
Garage Area
OF
UTILITIES
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin.
6.
TYPE ❑NEW 1:1 ALT.
1:1AD'N. El RPL.
ElMVE.
No. Baths
No. Stories
No. Rooms
No.
7, OF/
ElBLD. ElEr PLMB.
MECH. ElM.H.
11OTHER
11POOL
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION %? �/ SIGNATURE OF APPLICAN�/
Mech.
CERTIFICATE
Req'd.
Recd.
WORK
of EXEMPTION
I
ESCRIBE WORK
Enum Dist Location (Area)
I ) FEES COLLECTED
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Plans Examiner
SEPA Checklist
Building Technician
e--% /" r' 11)
PERMIT IS NONTRANSFERABLE
TOTAL $
WHEN MACHINE VALIDA7
THIS BECOMES A PERMIT.
1 ,
I 2j7 0 3'-8Y
i
238,8( *IZ00a-�J- -
VALUATION
SOU CE
GAS
ELECTRIC
WATER
SEWER
Ownership
(j
9. d
OF
UTILITIES
Public El Private ❑Single
$
I hereby certify that I have read and examined this application and have read the "NOTICE" provisio
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances gotype
Inuded
of work will be complied with whether specifiedherein or not. The granting of a permit does
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construperformance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION %? �/ SIGNATURE OF APPLICAN�/
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Plans Examiner
SEPA Checklist
Building Technician
e--% /" r' 11)
PERMIT IS NONTRANSFERABLE
TOTAL $
WHEN MACHINE VALIDA7
THIS BECOMES A PERMIT.
1 ,
I 2j7 0 3'-8Y
i
238,8( *IZ00a-�J- -