1982, 11-15 Permit G82B-1013 Gas Piping4.
PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — B,VROING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLI•CANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1�, (� ra
1.E. 1\C140 i WO-S �4 off.
LOT BLOCK SUBDIVISION
2.
ifiLIWNER
3. iMa..:1-)4 SS\033. ' tU.1.0 ki\N)D . 'cs
ADDRESS
Dig Rai'O Qdo
co�r0NTRP TOR
zN (aFtc V L )
ADDRESS
��. '&ate c_
5.
DESIGNER
PHONE
PHONE
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North _I South East (West
Size of Parcel
Type Const.
Valuation
Zone Classification
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
IJ NEW D ALT. ❑ D'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. �ECH. ❑ M.H. ❑ POOL
❑ OTHER
Area of Decks
No. Baths
Finished Basement
No. Stories
No. Rooms
Unfin_ Basement
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
Enum. Dist.
ILocation (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELE2TRIC
WATER
SEWER
Ownership
Public ❑ Private
USE CODE
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPEC1 S
DATE OF APPLICATION i/ (✓ dv+-- SIGNATURE OF APPLI'A T
01.1
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
/16,7 1--A-
FEES COLLECTED
Single $
Building
Plumbing
Mech. LE.
r
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL
$
PERMIT NUMBER I
saw- i a►�
G4* *12.00
* 1 2.006
A *0.00 8
101,22
11-15-82
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Building Technician
Mt
PERMIT IS NONTRANSFERABLE
11-'15 — 8 2
101.3z *12,002.' —
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL