1980, 09-02 Permit: 80-9450 Mechanical Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER �•` 1
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
r 01 NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES C 4 * * 2. 3. 0 0
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED " ' .y;-- '
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * L 2
.;.O 0
2. 1,, * 0 n ,
OWNER PHONE
3. 5 i.3a 6"A/PT qJ $'357 94IL9 <=
ADDRESS ZIP
Required Set Backs in Feet o
4I YAlV 5 L/ 12d tel 'y /�/t?. 9` 2a C North 'South East (West `
0
CONTRACTOR PHONE Size of Parcel Zone Classification n 7.Y.r, ` 4 7 9
L<<S r-()M H ./4 r i Al 4 Co , (L2 -?3/
4' ADDRESS /� ZIP Type Const. Occupancy Sprinklered
5 1./2- / 0 J 5 1 % N /"l I (' A ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE m NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 WORK CIBLD. CIPLMB. Il I MECH: CIM.H. ❑ POOL ❑ OTHER CERTIFICATE - Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. .2 /1f A T Pee M P S .1 E L JEc Ti'?i C FY 0 A /t/'c s FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of �/
9. utilities J` 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
Plumbing
performance of construction. 7
DATE ? — 2 7 — t 1.) !SIGNATURE 4/6 '' `��s-i-r'�4 /
- Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
rr
SEPA '_D
Planning _ w
n_
Fire Marshall Mobile Home
i
Co. Engineer Other (Specify)
Utilities
TOTAL $ 2 3 ,OCJ
Zone Clearance
44111b )
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist C:7/7--. .
1 THIS.B�COM�S A PERMIT.
DATE • FICIAL
API-ROVED FOR ISSUANCE