1980, 04-02 Permit: 80-3037 Mecanical FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER -�
DATE
VALUATION Source GAS ELECTR WATER SEWER
of
9. Utilities 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
Plumbing
performance of construction. JJ
DATEC(fkt ) SIGNATURE_ tlf Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer Other (Specify)
Utilities UV
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.' c
SEPA Checklist �/, Z, n �.
n ATF nFFiri Ai /1 ��( A�f, '41 P'il•1" 0 7- i. U
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
NUMBER/S
2.
I
JSUBUIVI510NPARCEL
OWNER -tom
� l LI
PV E—
3.
.!W�
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
C FA
TOR
OX,
PHONE
Size of Parcel
Zone Classification
4.
A
RESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes []No ❑ Req'd.
D
SIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
No. Baths
No.
Floors
No. Rooms
Rec. Room
TYPE 1:1 NEW El ALT. El AD'N. RPL.
❑ MVE.
7,
OF
❑ OTHER
❑ BLD. ❑ PLMB. ❑ MECH: ❑ M. H.
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
8.
C IBE WORK
i/ t , 1
FEES COLLECTED
PERMIT NUMBER -�
DATE
VALUATION Source GAS ELECTR WATER SEWER
of
9. Utilities 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
Plumbing
performance of construction. JJ
DATEC(fkt ) SIGNATURE_ tlf Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer Other (Specify)
Utilities UV
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.' c
SEPA Checklist �/, Z, n �.
n ATF nFFiri Ai /1 ��( A�f, '41 P'il•1" 0 7- i. U