1983, 01-05 Permit 83A-0070 Fuel Damper4.
6.
PLAN 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 DDRESS(57 '2
2
LOT
BLOCK SUBDIVISION
3. E ibt dJQ.4ga'„d
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COTRACTOR t'1 jajti `7
REST
SIGNER
,ADDRESS
CHANGE OF USE FROM
7
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TO
P NE
Z P
cl.aC
ONE
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
Main Floor
Upper Floors
Garage Area
Storage
TYPE
7, OF
WORK
'R NEW ❑ ALT. 0 /AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ECH. ❑ M.H. ❑ POOL
❑ OTHER
Area of Decks
No. Baths
Finished Basement Unfin. Basement
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
8.
9.
DESCCWO K
3LC_ f r _ ~ —
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECT
WATER
SEWER
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
I hereby certify that I have reed 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
`•Irmance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIOfj� _ n
OF APPLICATION ` "
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Not Rec'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. !
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL SAL, Q 21
PERMIT NUMBER
eA. s 0070
04 * * 1 4.00
* 1 4.00
A *0.00
69f
01-05-83
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE 0;
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED
�1
7,0z *1400°172
PERMIT NO. TOTAL