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1982, 10-06 Permit: 82A-9180 BoilerPLAN 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 1 LOT 2. BLOCK SUBDIVISION LEGAL DESCRIPTION - SEE ATTACHED OWNER U 3 h?LO ADDRESS 46w•u1Q DESIGNER 5' ADDRESS g,' -11Q30 ZIP PARCEL NUMBER/S Actual Set Backs in Feet North (South East West 4"4 -44 - ZIP PHONE CHANGE OF USE FROM 6. TO ZIP TYPE 7. OF WORK ❑ NEW t✓JALT. ❑ ADN ❑ RPL. ❑ MVE. ❑ BLD. ❑ PLMB.MECH. ❑ M.H. ❑ POOL ❑ OTHER v 9. 9. VALUATION SOURCE OF UTILITIES GAS ELECTRIC WATER SEWER Size of Parcel Type Const. Occupancy Valuation Main Floor Upper Floors Area of Decks No. Baths Zone Classification Sprinklered :Yes No ❑ Req'd. Building Area in Sq. Ft. Garage Area Storage Finished Basement Unfin. Basement No. Stories CERTIFICATE of EXEMPTION Enum. Dist. No. Rooms No. of Dwellings Location (Area) L- Ownership Public 0 Private 0 USE CODE Req'd. 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 authority to violate or cancel the provisions of any other state or local law r ,ulating cpnstr}Icy'on or tyle performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS DATE OF APPLICATION SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Enginee Utilities Plans Examine SEPA Checklis Building ician SIGNATURE OF APPLICANT SPECIAL CONDITIONS: /00 kiA civo 1W� S C'�� J ©01 l`tir PERMIT IS NONTRANSFERABLE Rec'd. Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. ..— Plan Check SEPA Mobile Home Other (Specify) TOTAL $ PERMIT NUMBER ,.q civ 04* *16OC *16006 A *000 8 917,92 10-06-82 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 10-06-82 918,02 *16,001F PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL