1980, 12-05 Permit: M80B-4521 Fireplace_AN NUMBER APPLICATION/ PERMIT
PERMIT NUMBE
SPOKANE COUNTY — BUILDING CODES DEPARTMENT �2 r
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESSI::cGAt DESCRIPTION —SEE ATTACHED
LOT_BLOCK SUBDIVISION PARCEL NUMBER/S
2.
3. OWNE zT
ADDRESS'7 /y� r/ ZIP Actual Set Backs in Feet
7
, m NorthSouth East West
CONTRACTPR
PHONE
Size of Parcel
Zone Classification
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Dyes [:]No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
rJ.
ADDRESS
ZIP
Main Floor
I Upper Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
No. Baths
No.
Stories
No. Rooms
No. of Dwellings
TYPE r�
W NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
], OF El OTHER
❑ BLD. ❑ PLMB. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK ,XMECH.
of EXEMPTION
/D5SC/R.jIIBE WORK
I
Enum. Dist. Location (Area)
FEES COLLECTED
8• / G! / 1/ l J� / F ' �� /` /I/ R
VALUATIO
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
O
1UTILITIES
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
ulating construction or the
to give authority to violate or cancel the provisions of any other state or local law, r!11A
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION�y
/Plumbing
nATF Or- APPI ICATinKi / 1L - 2 —P26 C,rAIATI IRF nr OPPI itANT //,/// .�Ld
Mech.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
-B.ij,ildi chniyan PERMIT IS NONTRANSFERABLE
,-e_ PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
)4* *7,00
*700 N
*7,00
A *0.00
452000
SEPA d
O
C.3
Mobile Home w
J_
QEve- Stf1W�y
Other (Specify) 4 C
TOTAL $�_
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
IZ-Q5-a0 452125
DATE ISSUED PERMIT NO.
TOTAL