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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..