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1981, 09-24 Permit G81A-9775 Gas Piping, BurnerPLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT PERMIT NUMBER NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 1. 2. 3. 4. 5. JOB ADDRESS! 3'7 )%• G-431If (C(� R_ c.AD LOT BLOCK SUBDIVISION OWNER ADDRESS %"."111 CONTRACTOR -C1,i-lr'Vr—rx'v ay Ibizz.Dr4a vL( 44N4 ' it��`ac HTf 4)6.1. ADDRESS N , itCC�rL�c,=rZ DESIGNER PHONE ZI P LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S Actual Set Backs in Feet North 'South PHONE Size of Parcel ZI P Type Const. PHONE Valuation Occupancy East 'West Zone Classification Sprinklered ❑Yes ❑No ❑ Req'd. Building Area in Sq. Ft. ADDRESS ZI P Main Floor f Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK OIL 6d NEW ❑ ALT. ❑ BLD. ❑ PLMB. TO ❑ AD'N. ❑ RPL. ❑ MVE. VMECH. ❑ M.H. ❑ POOL ❑ OTHER DESCRIBE WORK Pv -Pt ? fs.Y.) VALUATION 9. SOURCE OF UTILITIES TIES .2x...ki2,\;Et2. GAS ELECTRIC WATER SEWER Area of Decks No. Baths Finished Basement No. Stories No. Rooms Unfin. Basement No. of Dwellings f CERTIFICATE of EXEMPTION Location (Area) Enum. Dist. Ownership Public O Private LJ USE CODE Req'd. Rec'd_ Not 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 regulating construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSP TIONS C�' v` y ?) / f ta4 DATE OF APPLICATION f SIGNATURE OF APPLICAN �'� SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist SPECIAL CONDITIONS: to 6 ,r 1q FEES COLLECTED Single $ Building Plumbing Mech. �v Plan Check SEPA Mobile Home Other (Specify) TOTAL $ I�r` •c' 04* *18.00 *1800 *18.008 A *0.00 0 977,4z 09-24-81 z 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 8 'ding Technician PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE 9 4 4. DATE SUED _ 8 1 977,55 *.18,00a-- PERMIT NO. TOTAL