1981, 09-15 Permit: 81A-9354 Fuel Damper PLAN NUMBER APPLICATION/PERMIT
g,„ PERMIT NUMBER
ry SPOKANE COUNTY — BUILDING CODES DEPARTMENT
e IA - 9 �
( -/) NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS`s T•�ARD TO MAKE 3 COPIES
JOB ADDRESS (� * * 1
1. 1 .� .moi ;), f ( c)---± t LEGAL DESCRIPTION — SEE ATTACHED * 1 4.0 0
17,
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. * 1 4.0 0 Y
OWNER
PHONE
i
, .
A *
(,,a _i: yt_,
ADDRESS — ZIP ZIP Actual Set Backs in Feet 9 3 5,3 r?
/� ' l If--
CON R T 1 �� North 'South East 'West 0 9— 1 5—8 1
PIi. PHONE_ Size of Parcel Zone Classification
4.
ADDRESS' \t lb. -,�s,.0 l( [,�:a-ttitucii. .—vut 7 6-,Q1 G c 6,4 7 9•
_ jl _ Zip Type Const. Occupancy Sprinklered c
(_ • I 7to� `/ f
l�l !o, ❑Yes ❑No ❑ 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 Area of Decks Finished Basement Unfin. Basement
6.
TYPE No. Baths No. Stories No. Rooms No. of Dwellings
❑ NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER
WORK 0 BLD. 0 PLMB. 54 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
_ of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
8. -e- -Cee/ 66'yL !£i, FEES COLLECTED
VALUATION
SOURCE G 5 ELECTRIC VVATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑Private ❑
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included Single $
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 local law regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
.—:::::01
1' DATE OF APPLICATION �� SIGNATURE OF APPLICANT � �4 Mech. r .c,C,
l
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE - `� j
/ Plan Check
Env. Health /I / r) ,{ ,__.t ,
/1/�, - � 0-. I , ;A . (-- L,
Planning SEPA
UO
Fire Marshall —
Mobile Home w
7_
Co. Engineer
Other(Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
g kan �.� PERMIT IS NONTRANSFERABLE U�9i�'hI �'8 �L (I 3 5.'4 z *1 4 0 0 a }J- _
— PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL