1980, 09-09 Permit: 80-9808 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
'� ''
LEGAL DESbRIPTfON - SEE ATTACHED
1. le 7ZI
PHONE
Size of Parcel
Zone Classification
LOT BLOCK
SPARCEL
NUMBER/S
2. I
ZIP
Type Consq
Occupancy
OWNER
PHONE
3. ,
❑No ElReq'd.
PHONE
AD ESS
ZIP
Actual Set Backs in Feet
'� ''
North South East West
C . TRACTOR
PHONE
Size of Parcel
Zone Classification
r-
4' DRESS
ZIP
Type Consq
Occupancy
Sprinklered
.G.d8❑Yes
❑No ElReq'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
FJ.
ADDRESS
ZIP
Main Floor
I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin- Basement
6.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE El NEW ❑ ALT. El AD'N. El RPL. El MVE,
7, OF ❑ OTHER
El BLD. 1-1PLMB. ElMECH. ❑ M.H. 1:1 POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
FEES COLLECTED
8
VALUATION1 SOURCE I CAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
Q, ') �� UTILOITIES
Public ❑ Private ❑
��
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions incjdd
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governinBuilding
t' Y
type of work will be complied with whether specified herein or not. The granting of a permit does not pr
to give authority to violate or cancel the provisions of any other state or local law regulating construction
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION' SIGNATURE OF APPLICANT
SPECIAL APPROVALSI
SPECIAL CONDITIONS:
,,,, — --
Plan Check
Env.
Plann
gineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7 -
PERMIT NUMBER
D — 17.90
02* *1000
*1000
*100061
A *0.00 00
980,72
09-09-80
ii 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 9'x;1 V(o 9 8 0.8 .z
DATE ISSUED PERMIT NO.
k 1'0,0 0.°i
TOTAL
CL
C)
Q
W
J
V..