1980, 10-16 Permit: 80B-2104 Fuel DamperPLAN NUMBER APPLICATION/PERMIT 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
Jor "RESs LEGAL OESCHiPTION - SEE ATTACHED
LOT I BL-uuK BDI ISION PARCEL NUMBER/S
OWN P/
3. 2,// Z i
ADDRE
CO RACTOR
4. ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM ITO
6.
PHONE
�1�2,6_- �- �Ie y
ZIP
Actual Set Backs in Feet
North South East West
P ON
2 d1o�
Size of Parcel
Zone Classification
ZIP
O� f
Type Const.
Occupancy
Sprinklered
❑ Yes [-]No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
I Storage
Not Req'd.
Area of Decks
Finished Basement
Unfin. Baseme
TYPENo.
❑ NEW
❑ALT.
❑ AWN. RPL. ❑ MVE.
Baths
No. Stories
No. Rooms
No. of Dwellings
7, OF
❑ BLD.
❑PLM B.
/ ❑ OTHER
I!7 MECH. ❑ M.H. ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
D CRIBE O
n
Enum. Dist. Location (Area)
I I FEES COLLECTED
OF
VALUATION SOURCE GAS ELECTRIC W ER SEWER Ownership USE CODE
9. UTILITIES Public ❑Private ❑ Single $
1 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
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 INSPECTTIIOJNNy-S' Plumbing
r1ATF (1F APPI ICATIONI /O SI(_NOTI IRF ()F APPI WAKIT .Mech
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Hea
Planning
Fire Mar
Engineer
ns Examiner
PA Checklisl
rlsi,ing TeAfin7
n✓� PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 71
04* *7.00
*7,00
*7.006
A *0.00 CO,
21 0.39
10-16-80
z (x479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6 2 10. 4 U
DATE ISSUED PERMIT NO.
*7.00LO1-2
TOTAL