1980, 06-18 Permit: M80-5944 Mechanical FixturesIPLAN 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,_ alp (I J
3
LOT BLO K
OWNER �y
7 ltz '171
•'I,,")
SUBDIVISION
ADDRESS
CONTRA TO(61/4/
4. AD T1 ESS
�. ca YT
DESIGNER
5.
ADD R ESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
O PLMB.
ONE
ZIP
PHONE
ZIP
TO
AD'N. 0 RPL. 0 MVE.
MECH. 0 M.H. 0 POOL
0 OTHER
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
WATER
SEWER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North South East (West
Size of Parcel
Type Const.
Occupancy
Valuation
Main Floor
Upper Floors
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Area of Decks
Finished Basement
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Storage
Unfin. Basement
No. Rooms No. of Dwellings
ILocation (Area)
Ownership
Public ❑ Private ❑
Req'd. Rec'd. Not Req'd.
USE CODE
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 CI! /1-1)0
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
SEPA Checklist
B ng Te h ician - ^ '
SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
FOR GAS APPLIANCES
PIPE SIZES
PIPE LENGTHS
BTUS
•
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
J
ki7'0°
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ Q'01)
PERMIT NUMBER
04* *9.00
*9.00 ti
*9.006
B *0.00
594.32
06-18-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
594,45 *9.002 -
PERMIT NO. TOTAL