1988, 07-26 Permit App: 88002127 ResidenceSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I 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, 1 have read and understand the INSPECTION REQUIREMENTS/NOTICE provisions included herein and agree to comply with same. AU 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.
APPLICATION
',ATE
SIGNATURE OF
OWNER OR AGENT
LTETTA
ZPDKANE 9920
122 S SIOUX CIR
ADDRESE= YPOKANE !AIA 99206
.............. ....
NEW COUNTY ROAD APP
727-W -ao
................... .
.2212
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS:
5_ 3`7c7 o c'e
CITY/STATE/ZIP:
SUBDIVISION: X27/ L a '-
r
BLOCK: LOT: / 2 ZONE: DISTRICT:
LOT AREA: F/A:/ WIDTH:
# OF BUILDINGS: / # OF DWELLINGS:
OWNER: rr:;72-(:1'1'k-
DEPTH:/c9-S7"
R/W:
WATER DISTRICT:/L
PHONE:
MAILING ADDRESS: �, /��/ �i �e,e-c ('
CITY/STATE/ZIP:
CONTACT: //-"j.ti/� (-)de3,5
PHONE: 3,07e..)-"" ( -
SETBACKS: - FRONT: LEFT:3? RIGHT:/6 REAR:
PERMIT USE:
******************************************************************************
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
PHONE: -
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: / OCCUPANT LOAD: BUILDING HGT: STORIES: / 72
JT
BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: /200
REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT:
rico vir
rite) (,RFs
CA/Z7c__
CONTRACTOR LIC#:
CONTRACTOR:
PLUMBING.INFORMATION
MAILING ADDRESS:
***************************************************************************
MECHANICAL INFORMATION
CONTRACTOR LIC#:
CONTRACTOR:
MAILING ADDRESS:
ELECTRIC: GAS: OIL:
CCAL: WOOD: SOLAR: HEAT PUMP
ENERGY CODE: WSEC: NWEC:
UTILITY:
SGC:
APPROACH: PRESCRIPTIVE: POINT: COMPONENT: SYSTEMS:
***************************************************************************
MECHANICAL FEES
ITEM DESCRIPTION NUMBER OF
PROCESSING FEE YES OR NO
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEA'1'ER
GAS HTG EQUIP(100,000)BTU j
GAS HTG EQUIP +100,000
GAS PIPING - # OF UNITS '2-
HEATPUMP 1-100 BTU
HEATPUMP 101-500 BTU
HEATPUMP 501-1000 BTU
HEATPUMP 1001-1750 BTU
HEATPUMP +1751 BTU
REFRIG 1-100 BTU
REFRIG 101-500 BTU
REFRIG 501-100 BTU
REFRIG 101-1750 BTU
REFRIG +1750 BTU
AIR CONDITIONER 0-3 HP
AIR CONDITIONER 3-15 HP
AIR CONDITIONER 15-30 HP
AIR CONDITIONER 30-50 HP
AIR CONDITIONER +50 HP
VENTILATING FANS
EVAPORATIVE COOLERS
HOODS
CLOTHES DRYER
RANGE
GAS LOG
UNLISTED GAS APPLIANCE
AIR HANDLER 1-10000 CFM
PLUMBING FEES
ITEM DESCRIPTION NUMBER OF
PROCESSING FEE YES OR NO
TOILETS 2.
SINKS
SHOWERS
BATH TUBS
KITCHEN SINKS
DISHWASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
UTILITY SINKS
ELECTRIC WATER HEATERS
FLOOR DRAINS
FLOOR SINKS
BAR SINKS
ROOF DRAINS
LAWN SPRINKLER
SEWAGE EJECTOR
WATER SOFTENER
URINAL
DRINKING FOUNTAIN
611.70'
3.1
22
CENTER �!NE
S, LoR6-1A
&REMy i.c.
E. 12212 S�.ox+x Cit.
�
SpoICAhe L/ , Q Ip2(X
Ti -ask 6.6b 42.41-1,06
LOT 12; 85
MIDILOME ii -IL kid.
. '
$twle : �y6 � 1
SPEC. HOUSE
3?0'{ $. LORE7TA
<Pok.„e Lie, 99zb6