1981, 04-27 Permit: 81A-3965 Chimney PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
W.2 7/9/ SPOKANE COUNTY — BUILDING CODES DEPARTMENT (Pi A - 37 G 5
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
(7.)„,./ APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
1
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED :, ,,:
1. 5. 1520 sknoiooR-TN R.0314?
LOT BLOCK SUBDIVISION PARCEL NUMBER/S -154-S y I��� x ; ?' , `i y
Z. OWNER PHONE
3. DLL_ . �)ol}NSo1J `12.8-O79O 0 6 r'!
ADDRESS ZIP Actual Set Backs in Feet
S. 1520 SKIP IvO)Q-'TH R.ORP q32..0 Co North 'South —(west 7 - '7 — 1
CONTRACTOR PHONE Size of Parcel Zone Classification
sit Pir-
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.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ NEW ❑ ALT. ErAD'N. ❑ RPL. 0 MVE.
7, OF ❑ OTHER
WORK L�BLD. ❑ PLMB. ❑ MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum.Dist. I Location (Area)
8. CI11Ng/ CW►Ast) 12y) I Ns-nil 1ArT10tJ wR- 14../00.1) WOVE— I FEES COLLECTED
M
VALUATION SOURCE AS ELECTRIC WATER SEWER Ownership USE CODE
C— OF Public ❑Private 0
9. inn IA UTILITIES Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included oo -
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 nor
to give authority to violate or cancel the provisions of any other state or local la• regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTI• f ` Plumbing
7rDATE OF APPLICATION / 0-2T---- SIGNATURE OF APPLICANT / ,1 i'. 1/ LI Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: /
NAME DATE Plan Check
Env. Health
SEPA
r�
Planning
Mobile Home -I
Fire Marshall
Co. Engineer Other (Specify)
Utilities O..
TOTAL $ /O XK
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician ,��� PERMIT IS NONTRANSFERABLE O 4',•2' -'� '..I 3 9:6.5 5 *1 a 0 0 22 Pi
7 Al ' 1...
/`'��% GC�t> - �`� 1 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL