1980, 03-01 Permit: 80-2068 Mechanical Fixtures'PLAN NUMBER APPLICATION/ PERMIT PERMIT NUMBER
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
JOB ADDRESS
Aro so �` ��drz� LEGAL DESCRIPTION -SEE ATTACHED
LOT I BLOCK SUBDIVISI PARCEL NUMBER/S
OWNER
3.
ADDRES
,CO//N��TTJRRACCTOR
4. ADDRESS
1W d
r- /0Z %le
DESIGNER
�' ADDRESS
V'Y 4 "u, P
CHANGE OF USE FROM T
6.
PHONE
qa�i-3s.
Z I Ply p
PHONE
�y
w rI�
ZIP
qw
IPPw /e
PHONE
ZIP
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 OF ❑OTHER
WORK ElBLD. ElPLMB. ElMECH: ❑ M.H. ❑ POOL
Heq Ulrea Set backs In reet
FEES COLLECTED
North. South
East West
Size of Parcel
Zone Classification
GAS
ELECTRIC
Type Const.
Occupancy
Sprinklered
9.
of
Utilities
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
Single $
DWL Area
Basement Area
Garage Area
Storage
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
Split Entry 1
Split Level
Rancher
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
No. Baths
No. Floors
No. Rooms
Rec. Room
SPECIAL APPROVALS
CERTIFICATE
Req'd.
I Recd.
Not Rei
of EXEMPTION
Env. Health
DESCRIBE WORK �C
8• �� DL(t rG� ��PC —"Ll
FEES COLLECTED
.li �u L.•'�/4� //�'G �i/GY< Y
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9.
of
Utilities
Single $
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
Building
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.
Plumbing
DATE SIGNATURE—
G�
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
/11K %
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE j1'_ FFICI-Q-0 (�/^'v'w•
�— O AL
TOTAL $ 7 d
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.