1983, 03-14 Permit: 83A-1808 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.
5.
JOB AD RE
aO05
LOT BLOCK SUBDIV ION
OWNER
LEGAL DESCRIPTION - SEE ATTACHED
ADDRESS
‘-715-66 s kP /1(',e
ONTRACTIOR r
EISA 'PR14I` +C fr jO S
PHONE
ZIP
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South rEast (West
Size of Parcel 1 Zone Classification
ADDRESS
Zia_) d iTele ((/ 1U
DESIGNER
ZIP
9v 262
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
Z1 -NEW ❑ ALT.❑/AD'N. 1=1 RPL. l=1 MVE.
IBJ
❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
R
- .e1) ppr oezlea.
VALUATION
SOURCE
OF
UTILITIES
GAS
LECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public ❑ Private 0
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
LF
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
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)
TOTAL
PERMIT NUMBER
e7 tg08
04* *2000
*20.00
A *000
180,78
03-14-83,
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0`3`-14 83` 180.82 *20,00a. I- -
DA:TE ISSUED PERMIT NO. TOTAL