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1982, 04-14 Permit: 82A-2810 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY - BUILDING CODES DEPARTMENT Pt 024 ~ i 0 o....) NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES JOB ADDRESS 04 * * 2000 1. 10823 - 16th LEGAL P&&RIPTION — SEE ATTACHED * 20.00 LOT BLOCK SUBDIVISION PARCEL NUMBER/S 2. * 20004 OWNER PHONE 3. Richerd Grytness 928-1005 A * C00 E ADDRESS ZIP Actual Set Backs in Feet 2 8 0 9 . 10823 - 16th 99206 North !South East West CONTRACTOR PHONE Size of Parcel Zone Classification( 0 It- 1 4-8 2 4 Valley Fireplace Inc. 99037 6 4 7 9, ' ADDRESS ZIP Type Const. Occupancy Sprinklered 16610 Sprague Ave. ❑Yes ❑No ❑ Req'd. V©rada.le, ,dA DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. Contractor License No. VA 11, 1,Z 626 011 ADDRESS ZIP Main Floor Upper Floors Garage Area Storage — CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement 6. TYPENo.Baths No. Stories No. Rooms No. of Dwellings ❑ NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE. 7. OF 0 OTHER WORK 0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Recd. Not Req'd. of EXEMPTION DESCRIBE WORK Enum. Dist. I Location (Area) ' Install Blaze T rincess Insert-PIT-402FEES COLLECTED 8. i-1 7-os my rir }lane w-i .h haprt2 0,c-tension on I VALUATION SOURCE GAS ELECTRIC WATER SEWERUSE CODE Ownership OF 9. UTILITIES 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 ` 'Z.C7,Plumbing DATE OF APPLICATION t....../3.1;2__SIGNATURE OF APPLICANT // Mech. C7,©0 SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE Plan Check Env. Health SEPA n Planning :)v — w Fire Marshall Mobile Home ---1 i Co. Engineer Other(Specify) Utilities 0,0 TOTAL $ Plans Examiner WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist THIS BECOMES A PERMIT. Building Technician PERMIT IS NONTRANSFERABLE 0.4-ij..4,-'8 2 2 8 10 z *2 0.0'0 a 0,- v PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL