1981, 11-30 Permit: G81B-2232 Fire DamperPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILpING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. /1 /3 eol // '5'P' .1
SUBDIVISION
LOT
BLOCK
2.
3. /Z c ci L .
ADDRESS
4.
OWNER
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
5 re ars 0 �•
PARCEL NUMBER/S
. /-3 :t //
CONTRACTOR
f'!
e'Ll
ADDRESS
7
/). 7RC1 /�vGfGC,,tt
Actual Set Backs in Feet
North 'South
East
(West
PHONE
fug`s "2/"a
ZI P
901/60
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 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.
Recd.
Not Req'd.
DESCRIBE WORK
8. /.4s / i/ riK +<'
C mss. G✓ Q 1x ,L//-,
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
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
DATE OF APPLICATION //- I S 11:1/
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildin Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Crheck
SEPA
Mobile Home
Other (Specify)
TOTAL
/c, ca
$ /9". 4241
PERMIT NUMBER
'A3-
0*
223,12
11-30-81
g 6479,
* 1400
* 14.00
* 1 4.00'6
*000
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11-"3 a 81
DATE ISSUED
223.22 *1400._
PERMIT NO. TOTAL