1981, 09-23 Permit: 81A-9688 Mechanical FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
3
JOB ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
7
ADDRESS
rC 1"61 JC ) rh �. ` ynhis /5�
- l6 /06 i�fs Hr v4
CONTRACTOR I hat
t rso I,,
4. ADDRESS S L•(t EKf lic.,•JL�a`
( Sw) Jr f7/S filo n
DESIGNER \
JY.
PHONE.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
5.
ZIP Zo6
Actual Set Backs in Feet
North (South [East (West
1 �S �j
SREI
/46977,_06
Size of Parcel
Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
. Area of Decks
Finished Basement
Unfin. Basement
%NEW ❑ ALT.
❑ BLD. ❑ PLMB.
DESCRIBE WORK
B. ,kietti R Kul
VALUATION SOURCE
OF
9. UTILITIES
0 AD N. 0 RPL. 0 MVE.
s��y0 OTHER
yp MECH. 0 M.H. 0 POOL
r'n`) `f roti ale «-f- /MP CAC
GAS / ELECTRIC VA ER SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
Enum. Dist.
Location (Area)
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 R^/y/
REVERSE SIDE FOR REQUIRED INSPECTIONS
1/ 1
DATE OF APPLICATION• / ) O / SIGNATURE OF APPLICANT Cf-[. G/L4471---'
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
_—i -c h Mt—at /.pump
1 / v) £41L00 -t --
PERMIT IS NONTRANSFERABLE
5-0
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
0-6
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
)Q,6v
PERMIT NUMBER
slh-q6
04* *19.00
*1900 to
*19.006
A *Q00 3
9.6872
09-23-8'1
2 61179.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
9'6&8z *19.0'0a�
DATE ISSUED PERMIT NO. TOTAL
}
0
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