1981, 05-27 Permit: 81A-5122 Mechanical FixturesPLAN NUMBER APPLICATION/PERMIT
PER IT NUMBER �
tr
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
,`/l/J
JAS
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
G 4 2 2 O O
�' * 2 .
JOB ADDRES �
�,
LEGAL DESCRIPTION - SEE ATTACHED
* 2 Q 0
LOT
BLOCKISUBDIVISION
PARCEL NUMBER/S
*2200
2.
A 0 C 0 Cc)
OWNER 1
PHONE
3 IV
5 1 21 z
ADDRESS
ZIP
Actual Set Backs in Feet
North South East West
Q 5 - 2 7 - 8 1
CONTRAC,TPR
PHONE
Size Parcel
Zone Classification
of
494 -4 -WR
-9 6479.
4.&KA
ADDRESS
Type Const.
Sprinklered
�
W-7 .
[7Occupancy
❑Yes [-]No ❑ Req'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
6. b
No. Baths No. Stories
No. Rooms No. of Dwellings
TYPE ❑ NEW EYALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF//'' EJOTHER
1:1BLD. 1-1PLMB. R'MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Rec'd.Not
Req'd.
WORK
of EXEMPTION
I
DESC IB ORK
Enum. Dist.
Location (Area)
COLLECTED
i 40?/FEES
8. ,�
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
oU OFT
9, UTILITIES Public ❑ Private ❑
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
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 regulating constructhe
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO Plumbing
ATC nC ADDI lr"ATInfll �y IR —?� I Cl( klATI IOC nC ADDI InA— AAAI I O-t-uz Mech ;2 "1
SPECIAL APPROVALS
NAME DATE
iv. Health
anning
re Marshall
:). Engineer
tilities
ans Examiner
=PA Checklist
11l Tem
SPECIAL CONDITIONS:
`D moi-
IX 2
10,
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $�r
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
-0z �`-g `l' 5 122 z
*2"2 Q pa �-