1980, 10-06 Permit: 80B-1439 Conversion Burner PLAN NUMBERAPPLICATION/PERMIT ,�/`�. PE tidllT NUMBER g,0 e7 �`/y
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 0 4 * * 1 2.0 0
JOB AD ESS
1 CgQ1'D_ I2- LEGAL DESCRIPTION - SEE ATTACHED * 1 2. 0 0 N
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
* 1 2.006
2.
OWNER PHONE A * 0. 0 0 0
3. -At_( 0•k..1Z 535-iNZo
ADDRE{S�, ZIP Actual Set Backs in Feet 1 4 3,8 Q
Ct VINC North 'SouthEast IWest i 0-0 6-8 0
CONTR TOR PHONE Size of Parcel Zone Classification
(.,T+1 K16- 44 -4078 -2 6 4 7 9,
4. ADDRESS
�/� (/�°�jQ Z(yP� j Type Const. Occupancy Sprinklered
!v - (-+`�� L �rT ��ti�� —ig Ze' ! • DYes ❑No D Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO /` ^Q Area of Decks Finished Basement Unfin. Basement
6. (`a t l,._ C 3y S
TYPE I�J' No.Baths No. Stories No. Rooms No. of Dwellings
•
❑ NEW ❑ ALT. ❑ IfAlm. RPL. ❑ MVE.
7. OF _/ ❑ OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK ❑ BLD. 0 PLMB. MECH. ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBEWORK i ‘ I Enum. Dist. ILocation (Area) FEES COLLECTED
8. I S ill.L OOKIkr,„„,,, h,,,,,y‘t.,. I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. OF UTILLITIES %.74.-... Public 0 Private ❑
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 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 INSPECTIO , Plumbing
DATE OF APPLICATION 10- 2% .-) SIGNATURE OF APPLICANT #. -A• A .
Mech. igi
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE FOR GAS APPLIANCES Plan Check
Env. Health /
PIPE SIZES f SEPA
Planning
PIPE LENGTHS I Mobile Home - W
Fire Marshall
BTUS /OD,OO "
Co. Engineer Other(Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
ilding T ician PERMIT IS NONTRANSFERABLE 1 P L 0 '6,'-'8-O 14 3. 9.5 * 1 2' 0 0 ° r2 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL