1981, 05-06 Permit: 81A-4413 Mechanical Fixture (PLAN NUMBER I
APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT I
`'l - �•-92I
eiNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
7a'Z ? I *LEGAL DESCRIPTION — SEE ATTACHED 0 4 * * 1 8. 0 0
LOT I BLOCK 'SUBDIVISION
2. PARCEL NUMBER/S * 1 O O c~n
OWNER g
F i.Y�R �� rG PHONE
3 * 1 8 00c6.�
ADDRESS � LJI j5,z75 A * 000
5, `732.../.-7 „• ZIP Actual Set Backs in Feet
CONTRACTOR (tea North (South East (West 4 4 1,2 2.
�I - I 5A-TI ki 4 c 6 PHONEOSize of Parcel Zone Classification
4. IA (�/ I A ' ` j-��o b 0 5— 0 6—8 1
AD R SS 4�
1 �� �� 4t l� Jb� ljkr- ply, ZIP Type Const. I Occupancy Sprinklered [� 9
DESIGNER 9 ^�•� I C �"�1r/ yC ❑Yes ❑No 0 Req'd.
PHONE/ Valuation Building Area in Sq. Ft.
5. ADDRESS
ZIP Main Floor I Upper Floors I Garage Area I Storage
CHANGE OF USE FROM ITO
6. Area of Decks I Finished Basement I Unfin. Basement
TYPE EKEW 0 ALT. ❑ AD'N. 0 RPL. 0 MVE. No. Baths I No. Stories No. Rooms No. of Dwellings
7. OF '
WORK
0 BLD. 0 PLMB. L7 MECH. 0 M.H. ❑ POOL ❑ OTHER
CERTIFICATE Req'd. I Recd. 'Not Req'd.
DESCRI E/WORK I / of EXEMPTION
8. C%C)I�\p✓‘.fc.1\ IJ�r i./N. ! Ci co 000 Enum. Dist. (Location (Area)
VV Cl 6 c/t�1^N // .( FEES COLLECTED
9 VALUATION!UOURCESI GAS I ELECTRIC W14ER SEWER
F
I I Ownership USE CODE
Public 0 Private 0
I
I hereby certify that I have read and examined this application and have read the 'NOTICE" provisions included Single $
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 Building
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 INSP TIONS
r Plumbing
DATE OF APPLICATION r_ (
-- , ^ �) SIGNATURE OF APPLICAN 1114-114
a, /I1) Mech. 8.-
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health rl el` Ii I If — ii'' ) Plan Check
Planning C 4/2,"--'"
�it 'I) SEPA
// r
0
Fire Marshall
O
Mobile Home - v
LA..'
Co. Engineer
J
W
Other(Specify)
Utilities s
Plans Examiner TOTAL $
SEPA Checklist WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Bui n ectt ician PERMIT IS NONTRANSFERABLE tl
( � L,i p n p
V PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE uI U D o l�' N `f 13 Z *l a OT L F
DATE ISSUED PERMIT NO. TOTAL