1981, 07-30 Permit: 81A-7640 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
1.
2.
3
JOB ADDRESS
E 1'2,523 7th, Veradale Wash
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
Bill Cotton
PHONE
325-2576
PARCEL NUMBER/S
ADDRESS
E 15523 7th, Veradale
ZI P
99037
Actual Set Backs in Feet
North 'South
East
West
CONTRACTOR
4. ADDRESS
Personalized Servicg
North 926 Lake Road
PHONE
535-7333
Size of Parcel
Zone Classification
ZI P
99706
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors l Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
ALT.
❑ PLMB.
❑ AD'N.
O MECH.
O RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. oil to oas conversio
SOURCE
OF
9. UTILITIES
VALUATION
125,nn(1 RTU,a pi irar
WATER SEWER
GAS ELECTRIC
X
Enum. Dist.
Location (Area)
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
•
7/29/81
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
20' 1" oas pipe
10' 2" gas pipe
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 1q nn
PERMIT NUMBER
8/4 r6 d
04* *19.00
* 1900
* 19.006
A *0.00 E
763.9.:
07-30-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0`71-5 0-g• '1 7 6 40 Z
*19.00 -
DATE ISSUED PERMIT NO. TOTAL