1979, 08-08 Permit: 79-1807 Mechanical FixturesrI�AN NUMBER
i
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
C7 M tc_c_•, 1 �t r- C I)r� LEGAL DESCRIPTION —SEE ATTACHED
1. 'S. D
3.
OWNER
� ^LIS(Gr
Lcil L, N,<,
PHONE
S S c
ADDRESS 1�
1 V C X
l'
�� �t
ZIP '
�C� lT
Required Set Backs in Feet
NorthSouth
East West
CONTR CTOR
c� � C) r �
w r N U c -
PHONE
c, Ali- 2,
Size of Parcel
Zone Classification
4.
ADDRESS
y\
ZIP
9 F .3- t?
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE � NEW 11 ALT.
❑ AD'N. ❑ RPL.
❑ MVE.T
No. Baths
No. Floors
No. Rooms
Rec. Room
7.
OF
WORK 1:) BLD. ❑ PLMB.
5k MECH: ❑ M.H.
❑ OTHER
El POOL
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK 1 FEES COLLECTED
8.
VALUATION Source GAS ELECTRIC WATER SEWER
9, 1 1 Utiliofties /Vk
Single $
1 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
n (� OD
DATE SIGNATURE _ L' -t-` "! � Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE C� 1-217. FF AI
Plan Check
SEPA
Mobile Home
Other (Specify) -
7
/ • l%L9
TOTAL $ Q-4�)
PERMIT NUMBER
/1 __79 P 1,5()_7
gU_7
DATE � - I--1 �}
04* *7,00
*7.00
*7.00
A *0.00
1 80.6
08-08-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS,B�COI}(IF A PERMIT.
II II (UJ ' 0 180.%'
* n h.