1981, 05-08 Permit: 81A-4504 Mechanical FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (609) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
5. 3"C
LOT BL CK
0 007 i' i tT
SUGUIVISION
OWNER
3 L/ /,S Ca0.1.str(.4.0._74).'",. (B7/ 5N„
ADDRESS
S, .3a,6 ? AiirS
CONTRACTOR
4. A- VI:Wks old' 5 1/ 76' 4/d
ADDRESS
E. 7/5— Nit vsF1E D
5.
DESIGNER
PHONE
q ag — 338'0
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
ZIP
994
PHONE
`�2€—o iL 0
ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Actual Set Backs in Feet
North !South [East West
Size of Parcel Zone Classification
Type Const.
Valuation
Main Floor
Area of Decks
Occupancy
Upper Floors
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement Unfin. Basement
TYPE
7. OF
WORK
NEW
❑ BLD.
❑ ALT. ❑ AD'N.
❑ PLMB. ,MECH.
❑ RPL. ❑ MVE.
❑ OTHER
❑ M.H. ❑ POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Recd.
DESCRIBE WORK
8. is Kw FLt (4.cf work
Z, Raa.LtP
Enum. Dist. 'Location (Area)
VALUATION
9.
SOU RCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private 0
USE CODE
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 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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 6&-/g/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
ei/AArvt-Ct- 0
4-v
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
rG
(1
PERMIT NUMBER
�I �l -4504
04* *19.00
* 1 9.00 N
* 1 9.00
A *0.00
450.32
05-08-8.1
N 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
45445 *19.00a17' -
PERMIT NO. TOTAL