1980, 06-25 Permit: 80-6295 Mechanical FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
DATE
r [.
-01629.G
06-25-
6
6479
SCRIBE WORK
8
FEES COLLECTED ^
APPLICANT:
COMPLETE NUMBERED SPACES — PROS HARD TO MAKE 4 COPIES
of
JOB ADDRESS
9, Utilities
Single $
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK
SUBDIVISION
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
PARCEL NUMBER/S
2.
performance of construction.
Plumbing
SIGNATL)I+
�•
OWNER
Mech.
PHONE
DEPT. REQ'D. RECD.
Plan Check
Env. Health
C76
3
Planning
111
Mobile Home
Fire Marshall
ADDRESS
Co. Engineer
ZI
Required Set Backs in Feet
.5-110
TOTAL $
Ly /
�y/ -
North South
East West
WHEN MACHINE VALIDATED IN THIS SPACE,
CONTRACTOR
THIS BECOMES A PERMIT.
PHONE
Size of Parcel
Zone Classification
- -
4.
ADDRESS
^
ZIP
Type Const.
Occupancy
Sprinklered
`�7�� .,
,ntj �•
❑Yes ❑No ❑ Req'd.
DESIGNER
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
6.
No. Baths
No.
Floors
No. Rooms
Rec. Room
TYPE El NEW
1:1 ALT.
ElAD'N. 11 RPL. 1:1MVE.
7,
OF
❑ BLD.
❑ OTHER
❑ PLMB. ECH: ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
PERMIT NUMBER
DATE
r [.
-01629.G
06-25-
6
6479
SCRIBE WORK
8
FEES COLLECTED ^
VALUATION Source GAS ELECTRIC WATER SEWER
of
9, Utilities
Single $
1 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.
Plumbing
SIGNATL)I+
�•
DATER ��,/)
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
QZ�A�
`i
DATE�OFFICIAL
- -