1983, 03-23 Permit: 83A-2147 Mechanical FixturesPLAN NUMBER APPLICATIQN/PERMIT
SPOKANE COUNTY — BUILDI'NG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
q LEGAL DESCRIPTION — SEE ATTACHED
1 LOT BLOCK SU VISION PARCEL NUMBER/S
2.
OWN R �_ PHONE
3. as
ADITRESS
-ZIP
Actual Set Backs in Feet
1
9
��
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.DRES
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑No ElReq'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
s.
TYPE NEW ❑ALT. 1:1 AD'N. El RPL. El MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
7, OF ❑ OTHER
ElBLD. XIPLMB. ❑ MECH. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist. Location (Area)
8. I
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWEROwnership
USE CODE
9.
OF
UTILITIES
I
Public ❑Private ❑
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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or local law e ting construction or the
/!
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT I S
�'�'
Plumbing (21
DATE OF LJt—'
Mech.
APPLICATION -�— SIGNATURE OF APPLICANT
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
J
I
Plan Check
Env. Health
��.rr11// r. �^/�%
( — �rJ 1.fr I —/001 '✓
'"'WW,s�
Planning
!l111
— ,Cet- ) '.- /'.\ 1 / j
U/VLt�/`s / 1/,y
SEPA
Fire Marshall/
fJi
Mobile Home
Co. Engineer
/y �J
Other (Specify)
Utilities�91.
Plans Examiner
I
1- �i9t� 4 0-1/00 ke1--
1
PERMIT IS NONTRANSFERABLE
PFRMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
TOTAL $
PERMIT NUMBER
Ob� —2 W7
03* *65.00
*6500
A *000
214,670-
03 -23-83 4,6703-23-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
03=23-8'3 21472
nATF ICCI ipn PFRRAIT Kin
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