1981, 03-27 Permit: 81A-2819 Insert PLAN NUMBEF( APPLICATION/PERMIT Aei PERMIT NUMBER
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 0 4 * * 1 1 pp 00
1. 10205 3. 20th LEGAL DESCRIPTION — SEE ATTACHED t.0 C u
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 7,0 0 6
2. A * C.O C
OWNER PHONE
Torn Bisterfoldt 926-6763 2 8 1,8
3 ADDRESS ZIP 4 Actual Set Backs in Feet 0 3.2 7-8,1
10205 20th North !SouthEast 'West
CONTRACTOR PHONE Size of Parcel Zone Classification 4 b.4 7 9,
Valley Fireplace, Inc. 922-2780
4. ADDRESS16610 Sprague Ave. IP Type Const. Occupancy Sprinklered
"• 99037 Oyes ❑No 0 Req'd.
Vor
DESIGNER aaalc, .1h PHONE Valuation Building Area in Sq. Ft.
Contractor Specialty
5' ADDRESS io. VA IL f' 626 Oi, 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
Ids NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF El OTHER Req'd. Recd. Not Req'd.
WORK ❑ BLD. e❑ PLMB. MECH. 0 M.H. 0 POOL CERTIFICATE of EXEMPTION
DESCRIBE WORK L'stall "Blaze Princess" Rear Vent Enum.Dist. I Location (Area) FEES COLLECTED
8. \to fire ,lace.
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTI LLITIES Public ❑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 REVERSEStSIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION�7 ---/
/�/G' , SIGNATURE OF APPLICANT •S%� /�� ! Mech. I'
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health -eady for inspect'_• on.
SEPA
Planning O
_ U
Fire Marshall
Mobile Home W
ri
Co. Engineer Other (Specify)
Utilities )---,
TOTAL $ 1/.
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A�pPERMIT.
Bu'Iding Tech ian PERMIT IS NONTRANSFERABLE :0 3r 2,7' $,1. 2 8 19 z *17.0 0 a F
/}
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED°`' PERMIT NO. TOTAL
/