1981, 07-22 Permit: 81A-7321 Mechanical Fixtures(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
1.
2.
3.
JOB ADDRESS
1 LiiJJ
LO+ LOCK
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
O�WNNEF
_ X
ZI P
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South lEast 'West
�( NTRA T�R
4.
ARESS
�`.-}(\
DESIGNER
PH E
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
5' ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Storage
Unfin. Basement
❑ NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
O BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
8.
9.
DESCRIBE WORK
\c\
VALLTION
SOURCE
OF
UTILITIES
Enum. Dist.
u \\
ILocation (Area)
Req'd.
Rec'd.
Not Req'd.
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
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 INSPECTIONS
DATE OF APPLICATION
1
SIGNATURE OF APPLICAN
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
r f
6 U
I`750oAc) 13a-
irzw ---ro, J U LI 233j )15'i t N
-TH_ Ar-Yke---Moc►4.
PERMIT IS NONTRANSFERABLE
7,
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Go
Other (Specify) %C )X
TOTAL $
PERMIT NUMBER
8/A- 73ZJ
04* *19.00
* 1 9.00 5
* 1 9.006
A *0.00
73202
07-22-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE.
THIS BECOMES A PERMIT.
01,-2,2 -, 8,1.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
732,12 *19.00a�
PERMIT NO.