1980, 12-08 Permit: 80B-4558 Mechanical Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBE
SPOKANE COUNTY — BUILDING CODES DEPARTMENT M °C) i_9
() NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOBOMAKE3LEGAL DESCRIPTION - SEE ATTACHED 0 4 * * 1 3.0 0
1. LOS, 00 SUBDIVISI PARCEL NUMBER/S * 1 C ice`
2. * 1300•
OWNER . PHONE
3. c3 \ s r 'c.-c t owl R a.% -a'u$ A * e,c
ADDRESS \OI:\ , ZIP Actual Set Backs in Feet
.It)‘,ZCrs Fi :�--TT .0C<-%0 L S .r.J\Nc. `\`\abto North 'SouthEast (West 4 5 5 7
CONTRACTOR I PHONE Size of Parcel Zone Classification
12- 08-80
4. 0,....),__ \ !-\%., .N ANG .),\A „.. N`ya IoN,t- G- -1:11 i
ADDRESS � ZIPType Const. Occupancy Sprinklered 6.4 7 9,
e'ys l.�cC\ , 4>t, ,1� � `w.N . Qlcm Oyes ❑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.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE ("JEW ❑ ALT. 0 AD'N. 0 RPL. ❑ MVE.
7, OF �` 0 OTHERReq'd. Recd. Not Req'd.
WORK 0 BLD. 0 PLMB. WMECH. 0 M.H. 0 POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORKI
Enum. Dist. Location (Area)
�.?�T FEES COLLECTED
8. 'tc- STJ\U, Vc , \,tz H,t.c:h v-F c i `S --Th N t\e_a i fOcr w I
VALUATION SOURCE GASTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES D �/Q Public ❑Private 0
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
DATE OF APPLICATION \a^ V' � SIGNATURE OF APPLICANT( ky ech. +''
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check _
Env. Health
SEPA
, 5
Planning
a Mobile Home J
Fire Marshall '-'-
Co. Engineer Other (Specify)
Utilities
TOTAL $ ` .00J
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
�'ng'___---"i_1:4.41.____4'ng PERMIT IS NONTRANSFERABLE 1 2,--6 a 4 8 '0 4'5,5,8 z *1 3,0 0 °a`
�'�"f PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL