1980, 11-25 Permit: 80B-4199 Mechanical FixturesAPPLICATION/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
JOB ADDRESS
LOT
htt S.
BLOCK SUBDI ISION
3
4.
OWNER
ADDRESS
CLt
DESIGNER
ADDRESS
CHANGE OF USE FROM
TO
PHONE
ZI P
PHONE
ZIP
TYPE
7. OF
WORK
N/ NEW Afil ALT.
❑ BLD. D PLMB.
❑ AD'N.
❑ RPL.
MECH. ❑ M.H.
DESCRIBE WORK
•
VALUATION SOURCE I GAS
OF
9. UTILITIES ,(
❑ MVE.
O POOL
0 OTHER
cry ic4 �r:,� �.�a err •_..ttix
ELECTRIC
WATE R
SEWER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North
South East
Size of Parcel
Type Const.
Main Floor
Area of Decks
No. Baths
West
Zone Classification
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
Req'd.
Ownership
Public 0 Private 0
Location (Area)
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 j) 2 4 SIGNATURE OF APPLICANT VI /cL�
SPECIAL APPROVALS
N.'\ME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklis
SPECIAL CONDITIONS:
Ccs
6,4
3
3
3
3
Ig
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Storage
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
c�
TOTAL $
PERMIT NUMBER
8OB =1\99
04* *18.00
* 1800
* 1 Boni
*0.00 O
419.82
11-25-80
z 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11-.2.5-80
DATE ISSUED
419.92
PERMIT NO.
x,18.00Jo
0.
TOTAL