1980, 03-07 Permit: 80-1936 Fireplace PLAN NUMBER APPLICATION/PERMIT PERC«i'.:-N-U+:,'BER )
SPOKANE COUNTY — BUILDING CODES DEPARTMENT Al Fd— /93(
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE .- 7- VD
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1. L T BLOCK 5 BDIVISION PARCEL NUMBER/S 1 9 J 5
2.
OW ER d JI PHONE c J- {„ 7 - i
W., /9/2
�ZIIP Required Set Backs in Feet E.�- 7 9.
CONTRACTOR ACTOR �G�e`� PHONE Size of Parcel eo North (South East 'West
Classification
4• A DREE1 ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. El AD'N. ❑ RPL. El MVE.
7. OF ❑ OTHER MECH:
WORK ❑ BLD. CERTIFICATE Req'd. Recd. Not Req'd.
ElPLMB. KElM.H. El POOL
,F of EXEMPTION
DESCRIBE woRK /� !nawyviri,
FEES COLLECTED
8. l y%�� .T, • A" .C4°,S►�-
ALUATION. ., Source GAS ELECTRIC WATER SEWER
fE.- of
9r/it-el O of
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 Building
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 la, f.g lating co .truction or the
Plumbing
performance of construction. / •/ o 06
DATE.3 7--Rd SIGNATOR '� f �' ii 7/
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health ,4442-4
SEPA o
Planning — wa.
Mobile Home co
—
Fire Marshall --
Co. Engineer Other(Specify)
Utilities 4/...7 vd
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist , THIS BECOMES A PERMIT.
OP
:i ._ �.f r ,'� ,y. %: ";DATE OFFICIA1 3-7-yd IP,�. .. i ,�� 0 `3' 0 7.-8 0 19 3,6 *7, 0 0
LS uO
APPROVED FOR ISSUANCE -