1982, 03-12 Permit: M82A-1768 Stove, ChimneyPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. I, 451 1
LOT
2.
OWNER
3. kt\hr
ADgF3.[ESS 14
CO Ny /A
4. ADDRESS ��
BLOCK
LE(AL DESCRIPTION — SEE ATTACHED
SUBDIVISION
L- \J ( 0/1\1/vtJ l 4�) Ar,)C'
1°4'
H]O E
_ i57
,0?.2
PAki
RCEL NUMBER/S � M.+ "01(2,3
)
Actual Set Backs in Feet C771/4I'7 fJN(
North (South 1East
West
PHONE
Size of Parcel
ZIP
Te Cpnst.
Occupancy
Zone as ification
til L ii
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors ( Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
BIn EW El ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
LD. ❑ PLMB. DMECH. ❑ M.H. ❑ POOL
DESCRIBE WORK -
8. COU f Z\1 t
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
❑ OTHER
i
,=�tii`r)cr11NI
SEWER
ELECTRIC
WATER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public LJ Private Ei
Location (Area)
KBE CODE
Req'd.
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 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env.ealt )
c lit I�
Planning
Fire Marshall
Co. Engineer
Utilities
Plans
xamine
62.9
SEPA Checklis
Building
clan
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Notq'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
e 17(26
02* *2000
* 2000
* 20.006
A *000
1'76.62
03-12-82
2 6.479.
04* *2000
* 2000 rn
* 20,00
A *0.00
1'7672
03-12-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0�-12-82t 176.8 z *40.0021
DATE ISSUED PERMIT NO. TOTAL