1984, 03-07 Permit: 84A-1939 Mechanical FixturesPLAN NUMBER APPL MCAT I.ON /_ PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
'7
4.
APPLICANT: COMPLETE NUMBERED SPACES -
PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS_
ADDRESS
Z ry
Type Const.
PARCEL NO.
�. �
Y
A • /� 1
Ivy i' � f_
LOT
BLOCK
SUBDIVISION
New Const. Valuation
Remodeled Valuation
LEGAL DESCRIPTION:
2.
I
OWNER
PHONE
PHONE
3. �-; 4
a`
Greenhouse
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
CHANGE OF USE FROM
--
Cover Deck
Uncv. Deck
North South East West
CONTRACTOR
6.
T70
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
No. Baths No.
Floors
No. Fin. Room s
No. Dwellings
'-
Commercial El
'7
4.
—/(/L/f
ADDRESS
Z ry
Type Const.
Occupancy
Sprrte
❑Y� ❑No
Q V C�,'�'
'�6o�
❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
--
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
T70
No. Baths No.
Floors
No. Fin. Room s
No. Dwellings
TYPE �JVEW El . ❑ AD'N. ❑RPL. ❑ MVE.
7• OF El OTHER
WORK El BLD. ❑ PLMB.,�MECH. El M.H. El POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No ❑
DESCRIBE WORK q� .��I f ^ i ,� /�+
8. �i, ��(I IJJf'� �1
Shorelines/ Flood Hazard
Plans Required D
�Vf ��L i �,y�^ 0v()'�("
Yes El Not Applic. ❑
Received ❑
VALUATION I
SOOUFCE
GAS
ELECTRIC
PUBLIC WATER 1-1
SEWAGE SEPTIIC El
FEES FEES COLLECTED
9.
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
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
Building
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRED I S ECTIONS
Plumbing
SIGNATURE OF l�2Ci APPLICATION 3 —,r -LI
OWNER OR AGENT DATE
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
nv. Health
SEPA
Manning
Modular/
MFG. Home
'ire
Prevent.
Engineer
Other (Specify)
Utilities
PlansPERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building _ IN 180 DAYS
PERMIT NUMBER
TOTAL $ L .--
WHEN MACHINE VALIDATED iN THIS SPACE,
THIS BECOMES A PERMIT.
DATE 90 / _ PERMITI1 . 3, 9 z
* 5 0.0 0 -ROfAL
Y
a
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