1980, 01-09 Permit: 80-A-9957 Mechanical'LAN 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 4 COPIES
JOB ADDRESS
�.G. T1If�C.�IGy SUIVISION
2.
3.
4.
LEGAL DESCRIPTION - SEE ATTACHED
5.
OWNER
fl /Y#'i=N�40°TOr�! t'L>A1 -
ADDRESS
CONTRACTOR
/ 1 / H I %'X . /i /e /COA j ,
ADDRESS
/L6-
DESIGNER
PHONE
ZIP
99/4
PHONE
/f - S/
ZIP
99 ?cT
PHONE
PARCEL NUMBER /S
Required Set Backs in Feet
North 'South [East (West
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area I Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. /A%s i fiLL / a kuJ AIR triA17 LEI()
VALUATION Source AS
of
9. Utilities
ELECTRIC
x)c
WATER
SEWER
I hereby certify that 1 have read and examined this application and have read the "NOTICE" provisions included
on reverse side, ind 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 ofrconstruction.
DATE SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
'.one Clearance
==PA Checklist
SPECIAL CONDITIONS:
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7.012
AA-
DATE
PERMIT NUMBER
04* *7,00
*7.00 to
*7.006
E
*0,00
995.62
01 -09 -80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
/'� 1 THIS BECOMES A ERMIT.
DATE � ——BD3Q FFICIAL `� -^ � � � M - � O ,1 _ '0 9 9 5 7 Z
APPROVED FOR ISSUANCE
*1.00,a1-
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
•
•