1982, 09-13 Permit: 82A-8126 Chimney Ul NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT—se.VZ—.(0
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
I APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1. E C.:.-3 c)C. \c5--r`;
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 0 2 * * 2 G.0 0
2. ..6—P4-C2-e-- P.--- -c> tT tc7nJ
OWNER PHONE8 1 2 5 0
3 ADDRESS ZIP Actual Set Backs in Feet C 9- 1 J"V 2
E. . Cc.'3EjC.:::• ter-I•k CAS' ca North (SouthEast (West 6,L)7 9.
CONTRACTOR PHONE Size of Parcel Zone Classification
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
f - 1 Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5-6400
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
�/ No.Baths No. Stories No. Rooms No. of Dwellings
TYPE
Err" 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF �-,/ ❑ OTHER
WORK L1�B1+D. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
FEES COLLECTED
8 1`1\oksc5Fri( C.t l t l'/�t I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private 0
/ 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 it,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 law regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONSS ,,D Plumbing
DATE OF APPLICATION ?/i3/i 2 SIGNATURE OF APPLICANT �(�,,, _'4A. /J Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health _
SEPA ^-
Planning
,)
Mobile Home -r
Fire Marshall —
Co. Engineer Other(Specify)
Utilities .2.0-4:)°
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
B 5 ding Technician +^ PERMIT IS NONTRANSFERABLE 0=9 . 31-8 2- S 1 2,( z * 2 0. o�. I�-
r 0- PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL