1980, 10-14 Permit: 80B-1945 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
Tao
LOT BLOCK
SUSDIVIS10
NTRACTORr4.
et.
ADDRESS
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Ok
DESIGNER
ADDRESS
CHANGE OF X15
6.
TYPE
7. OF
WORK
PHONE
zfP
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PHONE
ZIP
TO
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPI ❑ MVE.
E pLD. ❑ PLMB. ❑ MECH. 0 M.H. 0 POOL
0 OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North South East (West
Size of Parcel
Occupancy
Valuation
Main Floor
Zone Classification
Building Area in Sq. Ft.
DESCRIBE WORK
tiW
9.
VALUATION SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
No. Baths
No. Stories No. Rooms No. of Dwellings
CERTIFICATE
of EXEMPTION
/psi Enum. Dist.
SEWER
Location (Area)
Ownership
Public ❑ Private ❑
Req'd. Rec'd.
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
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION / '- 9 `T 1 IS "J SIGNATURE OF APPLICANT
construction or the
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Q
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
04* *1200
*12.00
*12006
A *000
1944.-5'
10-14-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
r101-14 19452 *1200°� _
DATE ISSUED
PERMIT NO. TOTAL