1981, 04-03 Permit: 81A-3060 Mechanical Fixtures]PLAN NUMBER
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
APPLICATION/ PERMIT
SPOKANE COUNTY —&BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1 4RgSS �--� /'� / LEGAL DESCRIPTION - SEE ATTACHED
J2MO oB K �)ISUINUSIO I� ci PARCEL NUMBER/S
2.
3. !V�'•t�1
AD RESS
'
Z
Actual Set Backs in Feet
North South East
West
ONTRACT
P E
Size of Parcel
Zone Classification
� •n
.. CMZ
&�-10:5 '
4.
A D ES �(
2
Z
77Z�
Type Const.
Occupancy
Sprinklered
4104 1O
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
Area of Decks
Finished Basement
Unfin. Basement
s.
TO5
TYPE [AI
'L7 NEW ❑ ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
7 OF 1-1 OTHER
WORK 1:1 BLD. ElPLMB. ECH. ElM.H. 1:1 POOL
CERTIFICATE
Req'd.
I Recd.
Not Req'd
of EXEMPTION
DX -SCRIBE W K �� �O �� / '
8. ,���"I`
Enum. Dist.
Location (Area)
FEES COLLECTED
LUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
UTILOITIES
Public ❑Private ❑
Single $
1 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
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. S E REVERSE SIDE FOR REQUIRED INSPECTIO
a
&ZZDATE
Plumbing
v
OF APPLICATION SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
I S ECTAL CONDITIONS:
NAME DATE
Plan Check
nn
Tire marsnaii
Co. Engineer
Utilities
Plans Examiner
N 6 - 7,
rl P1110 = 2Z, 0
to, oo
I? -5`'
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
PERMIT NUMBER
04* * 1 9.00
*19.00 N
* 1 9.006
A *000 CO)
305,9
04-03-81
6.479,
Mobile Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6. ,
0 '4v- 013 _.181 3 0 d 0 Z
nATP IssllFn DCDMIT Kin
e
*19000.
Tr1TA I
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