1980, 03-13 Permit: G80-2241 Mechanical Fixtureff
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 4 COPIES
1.
2.
3.
JOB
LOT
RESS
BLOC/ UUBDIVISIO
OWNER
ADDRESS
ONC"
LEGAL DESCRIPTION — SEE ATTACHED
OURS TT-tut/14 jci ae/S
Saud-( r. —
PARCEL NUMBER/S
PHON
4at,�E-6773
ZIP
Rgao6
Required Set Backs in Feet
North 'South
East
'West
4'
CONTRACT6V4- I , jaV/�1 t COO
(1;1
ADDRESS
nc. 3603 Cry 1k'e
PHONE
4 44
Size of Parcel
Zone Classification
5.
DESIGNER
ZIP
a 1
PHO E
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM Qr
6.
Ip ALT.
0 PLMB.
7.
TYPE
OF
WORK
❑ NEW
❑ BLD.
❑ AD N.
MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
Split Entry
No. Baths
Split Level
No Floors
No. Rooms
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Reed.
Not Req'd.
DESCRIBE WORK r7 /+p
8. Lt, ( ®S OkUEEl/Sfdt� CaLAP4r
VALUATION P Source GAS ELECTRI WA ER
of
9. Utilities
SEWER
I hereby certify that I have read and examined this applicationand have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . 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 I:w regulating construction or the
performancrof cogstruction.
DATE d
30
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
•SEPA Checklist
SPECIAL CONDITIONS:
375' /"I
/6z h2 47-6c,
DATE OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /z
e6
DATE
IPA
PERMIT NUMBER
0-, 2 7
04* *1200
* 1200 N
* 12006
E *Q00 8
2.240•R
03-13-80
B 4479.
O
— U
0-
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
D 1:5.k;14'3r8`'pi
22.•4.15*120-Oi.Da�