1980, 10-14 Permit: 80B-1943 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 3 COPIES
JOB ADDRESS
LOT BLOCK
SUBDIVISIO
.k I tiv�
4.
CONTRAC R
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USROM
6. tk
TYPE
7. OF
WORK
TO
PHONE
t.
z113—
PHONE
ZIP
PHONE
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
1South East
North
West
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy
Main Floor I Upper Floors
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPC. ❑ MVE.
C�BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
8. �T �r Jul RNa �2 J', ✓
VATIOTV SOURCE GAS
OF
9. UTILITIES
ELECTRIC
❑ OTHER
yeAfoe611-0
WATER
Area of Decks
No. Baths
Sprinklered
Dyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
Storage
Unfin. Basement
No. Stories
No. Rooms INo. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
SEWER
Ownership
Public ❑ Private D
Req'd. Rec'd. Not Req'd.
USE CODE
I hereby certify that I have rea 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 INS'TIONS
DATE OF APPLICATION 1° — e –'� 0 SIGNATURE OF APPLICA �. ��._
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
P-1/ i
/
b
'LJ G^.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /(2--1
PERMIT NUMBER
04* *12.00
*12.00
*12,006
A *0.00 8
194,22
10-14-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 r -,1-t ,_: 8; ,
DATE ISSUED
1943,n *12.00a1-2
PERMIT NO.
TOTAL