1981, 03-18 Permit: 81A-2529 Mechanical FixturesPLAN NUMBER APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 611
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
:;4* *1�CC
1
1 2.0Cv
A
J G P
6479
CHANGE OF USE FROM
JOB ADDRESS
Area of Decks
Finished Basement
Untin. Basement
LEGAL DESCRIPTION —SEE ATTACHED
1.
AA9>
Q
I
No. Baths
LOT
BLOCK
No. of Dwellings
TYPE NEW 11 ALT. 13 AD'N. ❑ RPL. ❑ MVE.
NUMBER/S
2.
ISUBUIVISIONPARCEL
I
7, OF ❑ OTHER
OWNER
CERTIFICATE
Req'd.
PHONE
Not Req'd.
3.
of EXEMPTION
ESCRIBE WORK
'� e
Enum. Dist,
ADDRE
_
_ f
8
ZIP
Actual Set Backs in Feet
VALUATION
7
SEWER
Ownership
USE CODE
9.
OF ✓
UTILITIES
/
Public ❑ Private ❑
Single $
North South East West
CONT ACTOR
—4
Building
PHONE
Size of Parcel
Zone Classification
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
� � ' O
Mech. 7
DATE OF APPLICATION 13 0 / SIGNATURE OF APPLICANT ,,s cp
4.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
ADDRESS
ZIP
�+
'^
Type Const.
Occupancy
Sprinklered
�.
Mobile Home
Fire Marshall
❑Yes ❑No ❑ Req'd.
DESIGNER
Other (Specify)
PHONE
Valuation
Building Area in Sq. Ft.
5.
Utilities
TOTAL $ %
Plans Examiner
ADDRESS
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
ZIP
THIS BECOMES A PERMIT.
Main Floor
Upper Floors I
Garage Area
Storage
:;4* *1�CC
1
1 2.0Cv
A
J G P
6479
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Untin. Basement
s.
I
No. Baths
No, Stories
No. Rooms
No. of Dwellings
TYPE NEW 11 ALT. 13 AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
111 BLD. ❑ PLMB. a'MECH, ❑ M.H. El
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
ESCRIBE WORK
'� e
Enum. Dist,
Location (Area)
FEES COLLECTED
_ f
8
VALUATION
SOURCE GAS ELECT IC WA ER
SEWER
Ownership
USE CODE
9.
OF ✓
UTILITIES
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
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
� � ' O
Mech. 7
DATE OF APPLICATION 13 0 / SIGNATURE OF APPLICANT ,,s cp
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
�+
'^
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
%7
Utilities
TOTAL $ %
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
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