1981, 09-24 Permit: 81A-9773 Piping, BurnerNUMBER APPLICATION/PERMIT
PERMIT NUMBER
IPLAN
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
I NORTH Bit JEFFERSON / SPOKANE, WASHINGTON 99260 / (509)656-3615
(; 4. -I li
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
1. (5' P7.gol ADTH
LOT
BLOCK
NUMBER/S
I
ISUBDIVISIONFri
OWNER
PHONE
3. � ti 1 fear
ADDRESS
ZIP
ACtual Set Backs In Feet
G, r1P Co LUt M
rvoah South East west
'-r77 '
CONTRACTOR
PHONE
Sur, of Parcel Zone Clasalflcatlon
L::�s' f A
1.8-gal
_ _,,
G'd ca
4' ADDRESS
ZIP
Type Const.
Occupancy
SprmklemE
Aa• IU
i QI
Ell.,❑No ElReg'E,
DESIGNER
PHONE
Valuation
BuhEing Area In Sq. Fl.
6.
_
ADDRESS
ZIP
Main From Upper It..,,
Garage Area
5[ordge
CHANGE OF USE FROM
TO
Arca of Decks
Fn"uhed Basement
Dour. Basement
6. GIC.
J�a
CIAa
No. Baths
No, Stones
No. Rooms
of Dwellin91
TYPE NEW ❑ALT. ❑ qD'N. ❑ RPL. ❑ MVE.
INC
]. OF ❑OTHER
CERTIFICATE Req•a.
Rec•e.
Not Req•0.
BLD. ❑ PLMB. 61 MECH. ❑ M.H. El POOL
a
WORK
of EXEMPTION
DESCRIBE WORK
Form. Dist.
Lotatlon (Area)
6 chh5 7ptat pV` A N
FEES COLLECTED
VALUATION SOV RCE GAs ELECTRIC WATER SEWER Ow" ipUSE CODE
9. UTI LOITIES PapIIC DPnvate ❑
I
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
_
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or to• law regulating onshuction or the
Or
performance of construe Ion. SEE REVERSE SIDE FOR REQUIRED INSPE TI
Plumbing
C
March.
DATE OF APPLICATION—� SIGNATURE OF APPLICANT -
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
21' lh
2
al 4z
Plan Check
Fe.. Heaun
SEPA
planning
Mobile Home
Other ISpecifyl
Fire Marsnau
Co. engineer
uni it�es
TOTAL $1P;•C'Ys
Pians Examiner
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
IN THIS SPACE,
SEPA mrnckllsv.
PERMIT IS NONTRANSFERABLE
;Q g',-?'4'=6T
9 77.3 z •'1 & 0 0 ° -
a�uam� re hn
t lu
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED
PERMIT NO. TOTAL