1980, 05-01 Permit: 80-4226 Mechanical FixturesPLAN NUMBER
TO
APPLICATION/ PERMIT
Split Level
Rancher
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
6.
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESSy
No. Baths
No. Floors
LEGAL DESCRIPTION - SEE ATTACHED
Rec. Room
TYPE 1:1 NEW ALT. 1-1AD'N. ❑ RPL. L1MVE.
LOT
BLOCK
SUBDIVISION
r
PARCEL NUMBER/S
2.
Rec'd.
I
WORK
of EXEMPTION
OWNER
3. '41
P ONE
"s-�69. 2-
DESCRIBE WORK y (�/
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ADDRESS 'y7i // //
�f
8.-�/7SLCLlD� I �J /`�J 1��✓i .!�Q�
ZI/PPPj// //
Required Set Backs in Feet
VALUATION
�Q6� fl.�Ce
GAS
ELECTRIC
rYcR
North South East West
CONTIRACTOR y
of
utilities
PHONE
Size of Parcel
Zone Classification
Single $
1" kal AlLf lCZC9
��e�,��y
� lev7
a.
ADDRESSZI
aJ���/'y✓S�n/�
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
�a10
Type Const.
Occupancy
Sprinklered
❑Yes []No ❑ Req'd.
DESIGNER
Plumbing
PHONE
Valuation
Building Area in Sq. Ft.
DATE /��o SIGNATURE_ L "`
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
5.
ADDRESS
Env. Health
ZIP
DWL Area
Basement Area
Garage Area
Storage
PERMIT NUMBER
M
8O - A z
DATE
�..
4225
U 5— I — 0
Q 6479
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE 1:1 NEW ALT. 1-1AD'N. ❑ RPL. L1MVE.
7, OF1-1OTHER
❑ BLD. ❑ PLMB. MECH: ❑ M.H. ❑POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK y (�/
�Ql �i Qnu `7��
FEES COLLECTED
8.-�/7SLCLlD� I �J /`�J 1��✓i .!�Q�
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9, 0
of
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
Plumbing
perform nce of construction.
DATE /��o SIGNATURE_ L "`
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 $S-
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
THIS BECOMES AQPERMIT.
SEPA Checklist
� Q
DATESOFFICIAL