1980, 08-13 Permit G80-8528 Gas Hook UpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY =— BUILDING CODES DEPARTMENT
PERMIT NUMBER
ee-
4. ADDRESS
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES,— PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
I, 2-4 0 1 /I A'V17' I 1240
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.igA
BLOCK
OWNER
3. `%
Ip�``
ADDRESS I I of7-O
✓ 'rA.i 16
CONTRACTOR�
SUBDIVISION
pI = M 1 p l
PHONE
ZIP
99-1 PHONE
North
PARCEL NUMBER/S
Actual Set Backs in Feet
!South East
West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
8.
P NEW ❑ ALT. 2/MECH.
❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. Ifa MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
Hcrk
GAS ELECTRIC
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
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- regulating co ction or the
performance of construction. E RE ERSE SIDE FOR REQUIRED INSPEq`TIOF
DATE OF APPLICATION
Fd
SIGNATURE OF APPLICAisL
SPECIAL APPROVAL'
NAME ■'TE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Rec'd
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
04*
*4,00
*4.00 0)
852.62
08-13-80
2 6.479.
E * rn
85272
08-13-80
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Tec
PERMIT IS NONTRANSFERABLE
0 8 :l 5i'- 8.'0' 8 52. 8 0
*400°H
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED • PERMIT NO. TOTAL