1981, 07-27 Permit: 81A-7453 Mechanical FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
JOB ADRESS
LOT" BLOCK/ SUBDIV"1 2-E
OWNER
3
4.
5
ADDRESS
;J_
•..y ESS
DESIGNER
PHONE
ZIP
PHONE
3.
ZI P
4
LEGAL DEtCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South [East (West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
Elves ❑No ❑ Req'd_
PHONE
Valuation 1Building Area in Sq. Ft.
ADDRESS
ZI P
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
9.
RIBE WORK
2_40
ALUATION
2 2-7;
SOURCE GAS ELECTRIC WAT R SEWER
OF
UTILITIES
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that 1 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
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. S E REV RSE SIDE FOR REQUIRED INSPECTI NS
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVAL$
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
s/9e
91
PERMIT NUMBER
04* *19,00
* 1 9.00 N
* 1 9.006
A *000 0
7452
07-27-81
2 6479.
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
7�- 8'1
DATE ISSUED
ED IN THIS SPACE,
74,5.32
PERMIT NO.
*1 1.0 J L1