1984, 02-01 Permit: 84A-900 Mechanical Fixture PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
`7 ) SPOKANE COUNTY - BUILDING CODES DEPARTMENT 04 -Q 00
( / NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
/ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS • LEG-AL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OW ER PHONEU
3. 'Yll __) 12 �& -, 9. 7X—0 3.10? .
cel Required Set Backs in Feet
ADf1j2E55 i O� I / TI� ZIP North 'South East (West
CONTRACTOR L �/� ry, 6031-ti
��� �� 'PHHOO1N�E j�/�1yQ Size of Parcel Zone Classification
4' ADDRESS F� i 7 4 ZIP I"� � Type Const. Occupancy Sprinklered -'
/ ga tJ� ,I l [�C / Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL 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. 0 AD'N. ❑ RPL. ❑ MVE.
7. OF 0 OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK 0 BLD. ❑ PLMB. El MECH: 0 M.H. ❑ POOL
of EXEMPTION
SCRIBE NORK
8.
1U c J iyr) I U„L J� FEES COLLECTED
VALUATION urce GAS ELECTRIC WATER SEWER
of , /
9. Utilities V�
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
performance of construction. Plumbing
"Ai_
DATE .�' �/d'',(' ' I �8 SIGNATURE Mech. 19) CXD
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
aut.°�' ,♦1^A
Env.Health n ( , A/Y'\SLA__J
n..,�{ SEPA Q
Planning la 000 eft('
— I-
7�+++✓JJ- W Mobile Home
Fire Marshall
Co. Engineer / Icrt."0 �LiatiaLryl Other (Specify)
Utilities
TOTAL $ t�-/D '6)
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECQMESIA.P RMIT.
DATE OFFICIAL 0 2 -01' 8.'4' 9 0, 0 z * 1 8,0 0 d H
APPROVED FOR ISSUANCE —