1984, 02-14 Permit: 84A-1190 Mechanical Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY ei4A - L I 10
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. -- 7/ 4 ev .0,, �= '
LOT `6LOCK SUBDIVISIONLEGAL DESCRIPTION:
2.
I
OWNER PHONE PHONE
� t'
3. t- G/"' /cc", gei
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
North 'South East l West
CONTRR pTOR LICENSE` EXPIRES PHONE PHONNrEE / Size of Parcel Zone Classification Residential 0
4. .-7• r �,S, 1— •-.-- ii y✓-/,,I'9e. Commercial 0 v i� ,
ADDfRE ��-�� / ZIP Type Const. Occupancy Sprinklered
! 7 7 .&—* 1`'";"- Ai9,-i S ❑Yes 0N ❑Req'd. ` ,
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area ', 7`'
cam _
J. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement _
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE 'NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7• OF ❑ OTHER
WORK 0 BLD. 0 PLMB.&'MECH. 0 M.H. ElPOOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes No❑
{
DESCRIBE WORK '/ Shorelines/Flood Hazard Plans Required❑
8. ies �✓ e llajr. Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS E CTRIC 0 JWATEF( SEWAGE Ownership
9 OF x Pusuc❑ SEPTIC❑ FEES COLLECTED
UTILITIES PRIVATE❑ SEWER❑ Public❑Private❑
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 type of Building
work will be complied with whether specified herein or n.t. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any othe i •te or local law regulating construction or the performance
of construction.SEE REVERSE - - OR REOUI- -INSPECTIONS Plumbing
SIGNATURE OF APPLICATION — _�T
OWNER OR AGENT -: `—<— =- • DATE �I'G Mech.
' SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular/
MFG.Home >.-
Fire
.Fire d
Prevent. cmca
Engineer Other(Specify) LN
J
Utilities c;r 60 "
TOTAL ,"
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. .PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Budding
IN 180 DAYSc / / DATEWS2lED1 n8 GPERMrribu 9. 0 * 3 v,0 0 o0
if - 1AL