1981, 07-30 Permit: 81A-7614 Mechanical FixturePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
/ 4'C'C 5 G'G"v -e-
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3
OWNER
Lec' r ac
PHONE
`%t-7 74
PARCEL NUMBER/S
ADDRESS
ies
4. 4r.,4"(2‘,4,[7, ,Yrs f 11;'G t
ADDRESS
/a- 7/0
CONTRACTOR
ZIP
9f ?/Fo
Actual Set Backs in Feet
North 'South lEast (West
PHONE
/GCS
Size of Parcel
Zone Classification
ZIP/ 2
Type Const.
Occupancy
Sprinklered
❑Yes No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
O M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. r i7 , s
/-c
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
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
performar>,ce of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 7 - 7
SPELIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildi g Technician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. /CleL1',J
Plan( eck
SEPA
Mobile Horne
Other (Specify)
TOTAL $
PERMIT NUMBER
► `°t-
04* *14.00
* 1 4.00 17)
* 14.006
A *000
761.3
07-30-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
76145 *1400a�
PERMIT NO. TOTAL