1984, 02-01 Permit: 84A-902 Mechanical Fixture PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
• SPOKANE COUNTY — BUILDING CODES DEPARTMENT Ps -610-2
J NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
/l�J�/] �/�f _ l LCGAL DESCRIPTION — SEE ATTACHED
1 LO �BL/CK SUBDIVISION /� I PARCEL NUMBER/S
2.
OWNER PHONE
3. L a&Q qca —469 , ;
AD RESS - J2r� ZIP Required Set Backs in Feet >a- i
PO 0 1 0 to I J5 North (South East (West
CONTRACTOR to PH NE Size of Parcel Zone Classification I �`
C m �>( J . P C' y�47
4. ADQRES
U ZIP Type Const. Occupancy Sprinklered
( \ Q� 1 Ir` 0i 0 -YM
Elves ❑No ❑ Req'd.
DESIGNER ( 1 I + PHONE Valuation Building Area in Sq. Ft.
i " /!
5' ADDRESS ZIP OWL Area Basement Area Garage Area Storage ' -'
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER Req'd. Recd. Not Req'd.
WORK El BLD. ❑ PLMB. ECH: ❑ M.H. ❑ POOL CERTIFICATE
of EXEMPTION
D RIBE WORK
8. .1m Cannnt •
\ �� ^il 3 FEES COLLECTED
VA UA ION - S rce GAS ELECTRIC WATER 7 lY SEWER
of
9. Utilities t.., Single $ - —
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 Building
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
Plumbing
performance of4
' construction., /J�
DATE �.Aitifdi ,rri,.+! SIGNATURE 10 Mech. t o e L`
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. //o'{�� /� J Plan Check
Env.Health �j .A. /..dr`NIY_.'&.)
'7�00a /�,'/ u, SEPA
�.)r n�+ C
Planning C
I ,r Mobile Home
Fire Marshall /]/),� t'J If,1/�/•f/ tx�
Co. Engineer UI-/"� (`��`�" - a Other(Specify)
Utilities iC ae'
TOTAL $ - 0'
Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist TH ISd3rIrriA g4E4iMIT. o O J
DATE OFFICIAL
APPROVED FOR ISSUANCE —