1981, 04-22 Permit: 81A-3781 Mechanical FixturesPLAN NUMBER APPLICATION/ PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
j NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK S BD ISION I PARCEL NUMBER/S
OWNER
PHONE
3. If, le f / R k.a .r / W
Y --3,r--77,1,-2
ADDRESS
ZIP
Actual Set Backs in Feet
11 -OF k4x
50 ei
North South
East West '
CONTRACTOR
{.~
PHONE
Slag -,a/oc
Size of Parcel
Zone Classification
/I ../' /�Pa �
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
( ai. % %%7 ✓ : 1' d J G� /� v
. 16
❑ Yes ❑ No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
Baths No. Stories
No. Rooms
No. of Dwelling
TYPENo.
❑ NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% OF 11 OTHER
❑ BLD. 1:1PLMB. 1-1 MECH. ❑ M. H. El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
/p
Enum. Dist.
Location (Area)
FEES COLLECTED
8 r u / A h fip t,- ,,t h ` 6&S
V UATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USjorthe
9.
OF
UTILITIES
Public ❑ Private ❑Single
$
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances gover
type of work will be complied with whether specified herein or not. The granting of a permit does not
Building
to give authority to violate or cancel the provisions of any other state or local law regulating constructio
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
f!! UU
DATE OF APPLICATION~ SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu`ildin, technic PERMIT IS NONTRANSFERABLE
/^/fid 7 'R - C/cI
Plan Check
SEPA
Mobile Home
Other (Specify) -
0 4
Specify)
04* * 1 2.00
*12 00
* 1 200
A *000
3780
04-22-81
6479.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 °4 -2i �'-:'81i 3 7 & z * 12 0 0 to -