1982, 08-24 Permit: 82A-7417 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
JDDR7
L1. BLOCK
Li
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION
3.
4.
R
rtrek/' #Ii"
,91s-(
PARCEL NUMBER/S 7
ADDRESS
R
IP
Actual Set Backs in Feet
North 'South
East
West
O
ADDRES
� .
DESIGNER
5' ADDRESS
5TypePW
Const.
ON
Zone ZIP
ciSize of Parcel Classification
Valuation
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Garage Floors Area
Storage
CHA E, -�,OFUSE FROM
6. a
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
TO
C
Area of Decks
Finished Basement
Unfin. Basement
❑ ALT.
O PLMB.
❑ AD'N.
❑ MECH.
❑ R
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCR�E WORK
Enum. Dist. I Location (Area)
VALUA ON SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private 0
USE CODE
1 hereby certify that I have }dad 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
SIGNATURE OF APPLICA
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
uilding Tec icia 1 `
SPECIAL CONDITIONS:
4 4 PVPsU
jo o-() ernYVO RAkivyti-.)
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 1 c
i4
PERMIT NUMBER
0/4*
rl
A 4 0
*10.00
741.6::
—24-0 2
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 8 4.4 8 2
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT741 7 z *1 8. � �i