1981, 10-07 Permit: 81B-378 Mechanical FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
4.
JOB ADDRESS
/ /7 -
LOT BLOCK
SUBDIVIS�OO�/�.C,i*
LE{3AL DESCRIPTION - SEE ATTACHED
5.
OWN
ADDREfSS
CON ACTOR
ji
DESIGNER
c:49151QiNE 04.
ZIP
pi:LONE
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
__Size of Parcel
/-i
Type Const.
Valuation
Occupancy
East
West
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
O NEW
O BLD.
O ALT.
O PLMB.
0 AD N.
❑ RPL.
MECH. 0 M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTI FICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
9.
D SCRIBE WORK
VALUATION
SOURCE
OF
UTILITIES
AS
ELECTRIC
ATER
SEWER
Enum. Dist.
Ownership
Public ❑ Private ❑
Location (Area)
USE CODE
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
to give authority 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 INSPECTIONS
DATE OF APPLICATION /, 4/ /
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
(7f'
TOTAL $ _
PERMIT NUMBER
04* * 1 9.00
* 1 C.00
* 1 9,006
A *0.00 E
37,7
10-07-81
z 679.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0"7 = 8 '1' 3 7.8 z
DATE ISSUED PERMIT NO. TOTAL
190'0 pi