1983, 01-07 Permit: 83A-0138 Mechanical FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
LOT
2.
BLOCK
E. 11011 - 50th
SUBDIVISION
OWNER
.� R R. .- .. Janssen
ADDIFtESS — 50th Ct.
PHONE
928 9206
CONTRACTOR Valley Fire lace
rl r- -
4. ADDRESS
•
LICENSE
EXPIRES
1.610 Sp a„ue :eve
,Jori€r License J o . VALLEF-S260r.ii�i
ADDRESS
CHANGE OF USE FROM
•
PHONE
ZIP
5rE 2780
ZIP
99037
ZIP
TO
TYPE NEW 0 ALT. ❑ AAOF 'N. 0 RPL. 0 MVE.
7.WORK
0 BLD. 0 PLMB.�'MECH. 0 M.H. 0 POOL ❑OTHER
DESCRIBE WORK .Lnstall daze hing teireplace r'urnac
8• Insert i to ma o. -.1
VALUATION
9 UTILITIES
SOURCE
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
PARCEL NO.
1'
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North (South 1East 1 West
Size of Parcel
Type Const.
New Const. Valuation
Main Floor
Cover Deck
No. Baths
Zone Classification
Residential 0
Commercial 0
Spr'nklered
❑Yes ONo ❑ Req 'd.
Remode ed Valuation
Total Bldg. Floor Area
Garage/Storage
Uncv. Deck
No. Floors
Certifi. of Exempt.
or Variance
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes❑ No0
Received Yes Nor
Shorelines/Flood Hazard
Yee❑ Not Applic. 0
Ownership
Public 0 Private 0
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 type of
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law egulating construction or the performance
of construction. SEE REVE SE S DE FOR RE • U11.1.•• INSPECTION
SIGNATURE OF .IOPP' - 7 APPLICATION
OWNER OR AGENT DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
�7
SPECIALCONDITIONS: (SIE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Requ red ❑
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
PERMIT NUMBER
04* '*20.00
*20006
*C.00 8
13,78
01-07-83
2 6.4 7 9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQS1EDO 7 - 8 3
1 3. 8 c5*20.000.
PERMIT NO. TOTAL