1980, 07-15 Permit G-80-7076 Fuel DamperAPPLICATION/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 /J
1. S ' 2. ]) K'..! 1 G) l �t
LOT
2.
B OCK
3. AUb 4.)
,ADD ESS
CONTRACT.•
4. DDRESS
/. Iry
DESIGNER
5' ADDRESS
CHANGE OF
6.
SUBDIVISION
USE FROM
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
PAONE
%ze
HONE
PHONE
ZIP
TO
❑ ALT. 0 AD N. ❑ RPL. ❑ MVE.
❑ PLMB. MECH. ❑ M.H. 0 POOL
0 OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs In Feet
North (South
Size of Parcel
Type Const, Occupancy
Valuation
Main Floor Upper Floors
Area of Decks Finishc
No. Baths No. Stories
CERTIFICATE
of EXEMPTION
East 'West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area In Sq. Ft.
Garage Area Storage
No. Rooms No. of Dwellings
Req'd. Rec'd.
DESCRIBE WO
8.
VALUATION
9.
SOURCE GAS
OF
UTILITIES
Enum. Dist.
Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public D Private ❑
USE CODE
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
CAP
$ .r1
OLH *7,00
*7.00 4-1
*7.006
E *0,00
707.52
07-15-80
2 6479. .
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
70'7,65 *7,00,2; _
ing Te{hniclan
!L�
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED
PERMIT NO. TOTAL