1983, 07-21 Permit: 83A-6773 Chimney PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY —'�UILDING CODES DEPARTMENT ��`'77
C____.i NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB • I S LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK S DIVIS ONCCL- PARCEL NUMBER/S
2.
• R HONE
3. ' �o rt_ (5121/-37-7 L .
ADDRESS ZIP Actual Set Backs in Feet
North (South East (West
CTO n . /gyp 3 E'OI� Size of Parcel Zone Classification
4' AD RESS ,`` ' +(/`�/��ij� Zyf�,�j Type Const. Occupancy Sprinklered
,II Z31 1 Du«Ick. 1 IQ Oyes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft. v 4 2 0 0 0
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage * 2 0.0 0 chi —
A * 0 r 0
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement '
6. 677 % _c
TYPE No. Baths No. Stories No. Rooms No. of Dwellings
InEW ALT. 0 AD'N. 0 RPL. 0 MVE. 0 7—2'1 —8 3
7, OF 0 OTHER -
WORK
0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd. ,7 o
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area) r
8 -►—► i`JTAL-L_.. A4,nK q G. c3W , r` E \/ ntS r )j_ lx, FEES COLLECTED
VALUATION SOURCE GAS ELE TRIC WATER SEWER ownership
USE CODE
OF
9. UTILITIES Public 0 Private 0 Single $
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 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 l �'
DATE OF APPLICATION - `iq 463 SIGNATURE OF APPLICANT QG� Mech. ,�I 7
r.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning p
J
Fire Marshall Mobile Home
Cc_
Co. Engineer Other(Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
AllIiik
B .`r+illa i.an Q' , PERMIT IS NONTRANSFERABLE �'? �'�.l'-8g3. 6 7 7 3 z * 2 0' d —
A, PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL