HomeMy WebLinkAbout1980, 01-04 Permit: 80A-9789 Mechanical FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
�k G
PERMIT NUMBER
Pr i0 —ICN
JOB ADDRESS
1. g,/
LOT I BLOCK
2.
SuBH OOIV
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
3 CMRV C'OLC../AS
4.
ADDRE
/2D1. 1141_ail t/
CONTRACTOR
l a
s
ADDRESS
PHONE
ZIP
PARCEL NUMBER/5
99/�
PHONE
Required Set Backs in Feet
North 'South 'East (West
42 5a
9-9
999&0e
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area
Basement Are
Garage Are
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE X NEW
7. OF
WORK 0 BLD.
O ALT.
❑ PLMB.
O AD N.
❑ MECH
O RPL.
❑ M.H.
❑ MVE.
a POOL
0 OTHER
No. Baths
No. Floors
No. Room
Rec. Room
CERTIFICATE
of EXEMPTION
Reg
Recd.
Not Req
DESCRIBE WORK
8.1AISi ALLL S0, OLYJsru CAS FuR61ACr i-(cT WATe'pAn1K 0 `Tier WORK
VALUATION Source GAS ELECTRIC WAT R SEWER
of
J
9. Utllf les /� 54.
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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE l'N'S?A OFFICIAL
ariln MnA.aj !1
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $ /5.00
04* *1500
* 1500
* 15006
E *000-8
9788a
01-041-80
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. d
97 8.9'Z
*1 5.0,0 ?JP'