1983, 02-22 Permit: 83A-1214 Mechanical FixturesAPPLICATION/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.
3
4.
JOB ADO S _
C-2) S 7 'Li
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SSA DRESS
l c-70
SUBDIVISION
CO TRACTOR
)4k
D RESS •
DESIG ER
5.
ADDRESS
AL1
�FiONE
%12'(-cw
7c/0-37
PHONE
.,1101-1
N��,
PARCt.L NUMBER/S
Actual Set Backs in Feet
North (South
Size of Parcel
East
(West
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd_
Valuation
Building Area in Sq. Ft.
ZIP
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.
DESCRIBE WORFr`
8.
VALUATION
9.
O ALT.
O PLMB.
Ike
SOURCE GAS
OF
UTILITIES
❑ AD'N.
14--WIECH.
❑ RPL.
❑ M.H.
ELECTRIC
WATER
0 OTHER
SEWE R
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private ❑
Location (Area)
USE CODE
Req'd.
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 INSPECT! • S
DATE OF APPLICATION ±" l(' '—r% SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAkt CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
4
PERMIT Nu BER
A_
04* *14,00
*14.006
A *000
'121.32
02-22-83
2
6&79,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 2;4'2- -8"3
•
DATE ISSUED
12142
*14000. _J
-
PERMIT NO. TOTAL