1980, 11-25 Permit: 80B-4196 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
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1. O p Sd f�i � r'� '
LO BLOCK ISUBDIVISION PARCEL NUMBER/S
OWNER
3.
R
NE
vL &AC 0
ADDRESS
Z
Actual Set Backs in Feet
+
S t1 P/ W %
--:�0
North South
East West
CONTRACTOR
P ONE
Size of Parcel
Zone Classification
d S >cf �Le
o
.r
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
det 5, 1---5—
❑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.
Baths
No. Stories
No. Rooms
No. of Dwelling
TYPENo.
❑ NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 OF ElBLD. EJPLMB. �ECH. ElM.H. ❑ POOL El OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
8•
FEES COLLECTED
-� S Y '�4 � Yl1"IN IIN h
VALUATION
SOURCE
A
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
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 construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
d
�!
Mech. . GD
DATE OF APPLICATION a�7 8 SIGNATURE OF APPLICANT
SPECIAL APPROVALSI SPECIAL CONDITIONS:
NAME DATE
tnv. "eaun
Planning
Fire Marshall
Co. Engineer
Utilities
ans Examiner
B�IdiI TI hnicia•ry
n
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify) /
TOTAL $ /` O G
PERMIT NUMBERR
00,0_ /!
OG-* *11:00
*1C.
*1100
A *0.00
41 9.52
1 1 -25-80
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
41'9'6= *t LnnpL -