1981, 01-06 Permit: 82A-0084 Mechanical Fixture PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 8°2'4_ ee81
e
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ARES (I * . 1600
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION �� I ice t 01 ..
PARCEL K(JMBER3/S s'< 1 v 0 n
2. * 10, 00
,+� \t r ' ,:p4,7_,:,,,.4.;_,(i
3. OWNER I3/V Lv f ( V vvA ,1 A {` 0 n ` .`3
ADDRESS _,� f\ ZIP Actual Set Backs in Feet 3
�'(((y)){) �� North South East West v
CONTRAC R PHONE Size of Parcel Zone Classification 0 1 - 0 6-8 1
4. ADDRESS TypeConst. OccupancySprinklered
( ZIP �, 7 9
I - c)0 6 C l/4-_- ❑Yes DNo D Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5` ADDRESS ZIP Main Floor Upper Floors ( Garage Area Storage -
CHANGE OSE FROM TO Area of Decks Finished Basement Unfin. Basement
6. .
TYPE /LNo.Baths No. Stories No. Rooms No. of Dwellings
❑ NEW L+�AT. ❑ AD'N. D RPL. 0 MVE.
7. OF ,_ ' ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK` r
Enum. Dist. Location (Area)
8. `- S f/ CLiU 1 e475 t(rr� bvv itii I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF M / Ownership USE CODE
9. UTILITIES ✓ Public 0 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
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 r the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIO Plumbing
i �.
DATE OF APPLICATION ,— G �� SIGNATURE OF APPLICANT !L YL l Mech. 4�
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health 6
Od SEPA
Planning ,/ /ice 1 rje� / O
�/J3i I
Fire Marshall Mobile Home a
Co. Engineer — ( Other (Specify)
L
/ (1
��t
Utilities C/�i . - 2. P e
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician PERMIT IS NONTRANSFERABLE 01. -0 ('-'8 1, 8. 4 z *1 8. 0 0 a°
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL