1980, 09-16 Permit: 80B-286 Mechanical FixturesAPPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT SUBDIVISION!
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
3
4.
5.
6.
OWNER I C
ADDRESS
v& C 1,
PHONE
9z_ (6-(0-7 ;
PARCEL NUMBER/S
- R -1I Yl ,
CONTRA T ipp
ADDRESS
DESIGNER
ADDRESS
ZIP
PHONE
(?2 `6-zsem.
`142 C�Ce
PHONE
Actual Set Backs in Feet
North (South
Size of Parcel
Type Const.
Valuation
Occupancy
East IWest
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
CHANGE OF USE FROM
ZIP
Main Floor
Upper Floors
Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
8.
9.
TYPE
OF
WORK
❑ NEW
❑ BLD.
DESCRIBE WORK
VALUATION
❑ ALT.
❑ PLMB.
❑ AD'N. 0 RPL.
I3( MECH. 0 M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
ko-8--it„
Enum. Dist.
Location (Area)
5OURC
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
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 9- -
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
) /I
LIEratt-ON
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
I hCG
TOTAL $ CQ
1
PERMIT NUMBER
80c3 - 266
04* *600
* 6,00 07
* 6.00
A *000
281 2
09-16-80
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 0'
DATE ISSUED
28,6S5
DCQ,ArT nln
*6,00° -