1980, 09-22 Permit: 80B-639 FireplacePLAN NUMBER
942a/to
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
JOB ADDRESS
/t�
'3� I
L T, ( B OCK "I SUBDIVIOJ6�.��r
O NER
h�I-E�l
ADDRESS
74 :3 uu 4 i ade-
CONTRACTOR
4.�vL�L
AD • ESS..' e
DESIGNER
LEGAL DESCRIPTION - SEE ATTACHED
PARC.LNUME R/S
PHONE
ZIP
99.246
Actual Set Backs in Feet
North [South East West
5' ADDRESS
PHONE
Size of Parcel 1 Zone Classification
ZI P
Type Const.
Occupancy
Sprinklered
Yes ❑No ❑ Req'd.
PHONE
Valuation 1Building Area in Sq. Ft.
ZI P
Main Floor Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
SCRIBE WO
8.
let I-ATIO
sVALUTIO
2i0OD
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
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
SOURCE 1 GA
OF
UTILITIES
ELECTRIC
Enum. Dist,
ILocation (Area)
Ownership
Public ❑ Private ❑
USE CODE
DATE OF APPLICATION 9 C �L—Si l% SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bui mg Tech ician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
s'v/3-639
04* *3250
* 32.50 N
* 3250
A *000
638
09-22-80
z 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
90-12'21.-B'0,
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
3,9"z
PERMIT NO.
*32.5'0 -
TOTAL