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1983, 02-03 Permit: 83A-811 Fireplace PLAN NUMBER APPLICATION/PERMIT PERMIITy,UMBER SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY e2'- A- (I) NORTH 811 JEFFERSON/SPOKANE,NASHINGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 1 STREET/1DDRES3 t�� 4, �,{ PARCEL NO. 4- r.. D .,-2-co �y�2-co LQ,T UV BLOCK SUBDIVISION_ _�^�"' LEGAL DESCRIPTION: v 2. Cc> 00012 3. OWr I C`".1f 514\1 r:let, pr.. Y 4\1 -00,7 PHONE T, i Actual Set Backs in Feet to: K16 MA(jNG4. r 5,2.0 Ce7 North (South I`E4ast, I West r.-...... ' CONTE K E LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential Q 4. ���,,�,jjCommercial 0 • ADDRESS ZIP TypeCqutKi u ncy Sprinklered ❑Yes ❑No ❑Reg'd. DESIGNER PHONE New Const.Valuation Remodeled Valuation - Total Bldg.For Area 5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement 6. No.Baths No.Floors No.Fin.Rooms No.Dwellings TYPE 0 I.EW /ALT. 0 AD'N. El RPL. 0 MVE. 7. OF WORK BLD 0 PLMB. 0 MECH. 0 M.H. 0 POOL 0 OTHER Certifi.of Exempt. Required Yes No❑ Number or Variance Received Yes❑ No❑ 8. DESC �WQRKO, I � I Shorelines/FloodA Hazard Plans Required 0 �j IV Yes❑ Not Applic.0 Received 0 VAL A ION SOURCE GAS ELECTRIC WATER SEWAGE Ownership 9. ® UTILOITIES PRIVATE 0 SEWEPUBLIC 0 R 0 FEES COLLECTED Public❑Private>Z� 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 Building . .C.9 work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- thority to violate or cancel the • ovisions of any other state or local law regulating construction or the performance of construction.SEE REVE'- IDE FOR REQ IRED,N PECTIONS Plumbing SIGNATURE OF _ ~ . 6) / APPLICATION ..7_ OWNER OR AGENT /i A t= A'. -�I i'- /._i 4 SATE .� _ �--)C_ Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: ( ' E REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Plan Check Env.Health SEPA Planning Modular/ Fire MFG.Home y. LL Prevent. O Engineer Other(Specify) W J_ Utilities LL TOTAL $ SEPA WHEN MACHINE VALIDATED IN THIS SPACE, Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT. Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building o R 1 ` �' IN 180 DAYS; DATE EDO 3 8 PERMIT NO IL 1 z * 2 O.0 01fbtAL Tech. Jl