1980, 01-28 Permit: 80-595 Mechanical FixturesPLAN 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 n
4 e
L T 1 BLOCK
_
LEGAL DESCRIPTION - SEE ATTACHED
2.
5U I 1510
PARCEL NUMBER/5
OWNE
3 / e
A DRESS ` �t�
?/�. j SDG -QP R"A
C—�/N/jTR.'�ACTTO �p /�� �6
4' ADDRESS �it'dLGC-��'�� "V
'�sl / / /} `"p4- i1 JJ -2� I
DES)GNER
5.
PHONE
92 93)7
ZIP
9vg./6
Required Set Backs in Feet
North !South East 'West
PHONE
2c9-2ko
Size of Parcel I Zone Classification
ZIP
99e/6
Type Const.
Occupancy
Sprink1ered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area f Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
MECH:
❑ RPL.
El M.H.
D MVE_
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
D SCRIBE WORK.
8.
VALUATION
9.
ems(/Dal6 06 LTU
WATER
Source
of
Utilities
GAS
ELECT C
SEWER
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 stter local law reguling construction or the
performance of construction.tr
DATE/ ' P-8'47 47 SIGNATURE .'Y1,19.6 141-V
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health •
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL ON (TIONS:
ei / '/ RIPE
DATE OFFICIA
sAa elad,�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. 1/-2
Plan Check
SEPA
Mobile Home
Other (Specify)
eb
TOTAL $
PERMIT NUMBER
�s --s93-
DATE/—.2;? ,7d
0 p. *
* 1200
* 1200 rz
* 12006
E *Q00
59,4B
01-28-80
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. Z * 1 O Q a l-
0 1.1-2'8=8'01 9 7.5 J
•
RECORD OF INSPECTIONS
Final Inspection
REMARKS INSPECTED BY
01 -56—
��rtb
av�)l `ss
�►1500R
'.I
J S'? 0
'LJ500