1980, 07-03 Permit: 80-6645 Mechanical Fixtures PLAN NUMBER
APPLICATION/PERMIT PERMIT NUMBER, r. .
SPOKANE COUNTY — BUILDING CODES DEPARTMENT _6 " 40'
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 41 1� .0, -,"
V APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 4
JOB ADDRESS . O 4 * *7.0 0
1 C/ i ?WC?63, 4( RC1.�/� LEGAL DESCRIPTION - SEE ATTACHED F
LOT BLOCK' SUB (VISION " PARCEL NUMBER/S *7.0 0 to
2.
*7.00U
OWNER 4-)44 iPHONE
3. Gr/! eLt ti
-`���la�luL
�{ n��'_ �g 4S� E * 0.0 0
ADDRESS /� t, �, Zip I�� /�,� Required Set Backs in Feet 6 6 4,4
—. / - qq ao 6 North 'South East (West
CONT ACTOR P, N Size of Parcel Zone Classification 0 7-0 3-8 0
4. re 2L r c C4 C9 r��`�+ ... v078 4 7 9,
ADDRESS�p 1� � , '/ /� ZIP ^� Type Const. Occupancy Sprinklered
it) 33 /1 V 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. V6'AD'N. ❑ RPL. ❑ MVE.
7, OF CI OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK I=1 BLD. ❑ PLMB. -MECH: ❑ M.H. ❑ POOL +
of EXEMPTION
DESCRIBE WORK , P ,\
8. FEES COLLECTED
�t�C.r r 9 j1�i�U(, V� ' c
VALUATION Source GAS ELECT WATER SEWER
of
Q, Utilities
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 construction. 4...7 Plumbing
DATE 7 // / P c SIGNATURE L C /t Mech. 4 2.O0
SPECIAL APPROVALS SPECIAL CONDITION
DEPT. REQ'D. RECD. (rev Plan Check
Env. Health & c to ��� b „�A..
SEPA
PlanningI�
��E4, ,��,„:Atuett ` , wi .... L,..,
Mobile Homecii
Fire Marshall T
Co. Engineer Other (Specify)
Utilities
TOTAL $ 7t Od
Zone Clearance t
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist �!_ `/ T THIS r:,B/COM PA ERMIT.
DATE 7/3/8° OFFICIAL ,lf<1�///O 579-1-
� ! "'" r �,5 * �, (-
APPROVED FOR ISSUANCE _