1982, 10-04 Permit: 82A-8997 Chimney PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
I SPOKANE COUNTY - Bt RMING CODES DEPARTMENT 1;1-A - i>1997
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
E // APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS1.
..� LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S x 2(, 0 i Y
2.
OWNER 1 PHO E f
3. r � —LJ 11 q r c- c
ADDrESS n ^� p Imo, P Actual Set Backs in Feet 5" 1�
✓ l /�C' 1 1 FeAL l 0'77 7 North (South East 'West 1 0— C (1 _'8 2
CONTRACIpc PH NE Size of Parcel Zone Classification
4. ADDRESS ZIP Type C nst. ccupancy 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.
TYPE � No.Baths No. Stories No. Rooms No. of Dwellings
D NEW ❑ ALT. E AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER
WORK NLLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not q'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
8. y_1\ fIre I C1 6 i FEES COLLECTED
�
VALUATION SOURCE GAS ELECTRIC WATER SEWER /
OF Ownership ISE CODE
9. 2;0 G" UTILITIES Public ❑Private IC—Y/ 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 2. C'
type of work will be complied with whether specified herein or not. The granting o a permit does not presume Building
to give authority to violate or cancel the provisions of any other state or local law r•• lating eonst .r . t e
performance of construction.SEE REVERSE SIDE FOR REQUIRED (NSP TIONS I Plumbing
j I �� /
DATE OF APPLICATION 0 - \ `? IGNATURE OF APPLI ' — �i. J .�� L' Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
I.
NAME DATE Plan Check
Env. Health
SEPA is
Planning <
—
Fire Marshall Mobile Home :
L
Co. Engineer Other(Specify)
Utilities •�d
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
inBO
,'t""echnic n� PERMIT IS NONTRANSFERABLE ` 04-8
' i' 2 899.72 o *20.00aO ►J -
i F PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL