1987, 07-29 Permit App: 87002391 AdditionSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
NORTH 811 JEFFERSON
SPOKANE, WASHINGTON 99260
(509) 456-3675
1 certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct. In
addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE provisions included herein and agree to comply with same. All provisions of laws and
ordinances governing this type of work will be complied with whether specified herein or not. I understand that the issuance of this permit and any subsequent inspection
approvals or Certificates of Occupancy shall not be construed to give authority to violate or cancel the provisions of any state or local law regulating construction, or as a
warranty of conformance with the provisions of any state or local laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
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* INFORMATION WORKSHEET
******************************************************************************
*
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* PARCEL NUMBER:
*
j
*
* STREET ADDRESS: '"
*
* CITY/STATE/ZIP:
*
* SUBDIVISION:
*
* BLOCK: LOT: ZONE: fes', DISTRICT:
* I
( q O
*
* LOT AREA: F/A: WIDTH: DEPTH: R/W:
*
* # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
*
* OWNER - PHONE: �D9
*
*
* MAILING ADDRESS: ��; 13 C)lrlG Rd
*
* CITY/STATE/ZIP:
* CONTACT: PHONE: - -
*
* SETBACKS: - FRONT: LEFT: RIGHT: REAR:
* 6E J I&
PERMIT USE:
*
* BUILDING INFORMATION
*
* CONTRACTOR LICENSE NUMBER:
*
* CONTRACTOR: PHONE: - -
*
* MAILING ADDRESS:
*
x
* ARCHITECT/ENGINEER: PHONE: - -
*
* MAILING ADDRESS:
*
*
* NEW: REMODEL: ADDITION: CHANGE OF USE:
*
x
* DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
*
*
* BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.:
*
x
* REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT:
*****x********x******xx*******************************xxx**xxx***x****xxxx****
NGQILE FCNE INFCRNATICN #
*
*
CCNTR LICK:----------------------------
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CONTRACTOR:-------------------------------------- PHCNE:----------
-------MAILING
MAILINGA C GR E S S:------------------- ------------------------
*
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PREVICLS ADDRESS:_____,_____
#
LOCATIGN:---__– FARCEL NLNeEP:___________ ------ – -----
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STREET- a
-------------------
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CITY/STATE/ZIP :----------- -----------------------------------
#
'4AKF:-------------------------- NCDEL:--------------------- ;
*
*
SCEP IAL h :____________________----__ I. I DTF::__-- L ENCTF- :----
#
RELCCATICN INFCRNATICN
CONTR LICk: -
*
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C G rd T R AC T C F=------------------------ ------ ---- F F C n E=---- ---- -----
#
MA I L I N G A J C R E S S:------------------------------------------------- ------
PREVIOUS
LLCAT ICN:PARCEL NUP2ER:______
S IRE ET =---------------------------- — —
CITY/STATE/ZIP:--------------------------- --------------------------
#
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SIGN INFCRNATICN
*
CONTR LICK: ---------- ------
*
T
#
CONTRACTOR:__-- --------__
*
MAILING ADDRESS: ----------- ------------------------
*
SQUARE FOOTAGE:_ -- POLE
#
OENCLIIICK INFCFNATIC
*
CONTR L ICR:_
*
CCNTRACTOR:—___— ' _ _ FHCNE:---_ -- _ #
*
MAILING ADDRESS -------------------------------------------------
BUILCING SCUARE FOCTACE:
--_--
NUNBER CF BUILGINGS:—
a - PLUNOINC INFCRMATION
* CONT R L I C =------------------------- '°
* CONTRACTCR:----------------------------- ---------- PFCNE:--------- — #
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* NAILING ACCFESS:--_—_ _ +
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* MECHANICAL INFORMATION x
*
CON IR LIC4=------------------------------ r
* C0NIRACTGR:---------------------------------------- FFcNE=–
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# MAiL1NC ACCRESS:-------------------------------------------------
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ELECTRIC:_— CAS:CIL:–__ CCAL:-- hCGD:___ SCLAR:_–_ FE!T FUNP:_–_ r
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MECHANICAL FEES PLUMBING FEES
IlEim DESCRIPTION
PROCESSING FEE
DUCTWORK SYSTEM
wOCCSTCVE/I&SERT
GAS WATER HEATER
GAS t -TG EQUIP<10C.000>8TU
6AS hTG EQUIP+100,000 BTU
GAS PIPING – 9 OF UNITS
HEATPUMP 1-1O0M ETU
HEATPUMP 101-5001, BTI;
HEATPUMP 501-1,COOM BTU
HEATPUMP 1,001-175OM BTU
HEATPUMP +1,750M BTU
REFRIG 1-10OK BTU
REFRIG 101-50OM BTU
REFRIG 501-1,00OM BTU
REFRIG 1,001-1,750M BTU
REFRIG . +1,750M BTU
AIR CONDITIONER 0-3 HP
AIR CONCITICNER 3-15 hP
AIR CONDI TICNER 15-3C HP
AIR CCNC.ITICN-ER 30-50 HP
AIR CONDITI-GNER +50 HP
VENTILATING FANS
EVAPORATIVE COOLERS
HOODS
CLOTFES DRYER
RANGE
GAS LOG
UNLISTED GAS APPLIANCE
Alli HANDLER 1— I OGOG CFM
AIR HANDLER 10000+ CFM
NLHBER CF ITEM OESCRIPTION NUHBER OF
YES OR NG PROCESSING FEE YES OR NC
_ TOILETS
SINKS
SHOWERS
_ OATH TUBS
KITCHEN SINKS
DISH WASHERS
GARBAGE DISPCSAL
_ — CLOTHES WASHER
UTILITY SINKS'
ELECTRIC %%ATER HEATERS
FLOOR DRAINS _
FLOCP SINKS _
BAR SINKS
ROOF CRAINS
LAWN SPRINKLE" _
_ — SEWAGE EJ-ECTGR _
WATER SOFTENER
URNAL
DRINKING FOUNTIAN
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