1984, 02-24 Permit: 84A-1575 Mechanical FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. e—. /q 7 o 7 — /7* 4v
411111111111111
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. /M?Tis r/G caAts %R,
MAILING ADDRESS
/Y7 /s /7
CONTRACTOR
4. fiIV DFRS o Ar S //
ADDRESS
% 63 7-O.I/1T /¢ //e
PHONE
7;2e-`/6,-7/
PHONE
LEGAL DESCRIPTION:
LIe N$E EXPIRES
ZIP
99:/W
PHONE
g—(n0
ZIP
99 /
Actual Set Backs in Feet to:
North 'South [East I West
Size of Parcel Zone Classification
Type Const.
Occupancy
Residential ❑
Commercial ❑
Sprinklered
❑Yes ❑No ❑ Req. d.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
7.OF
TYPE A NEW ❑ ALT. E AD' N. ❑ RPL. ❑ MVE.
WORK ❑ BLD. ❑ PLMB. , MECH. ElM.H. ElPOOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes ❑ Non
Received Yes❑ Non
Number
DESCRIBE WORK
8. /�) Fel.'Air/9C'-E � pct c_ i — r.4)(.9,e1‹
VALUATION
SOURCE
UTILLIITIES
9.
GAS
ELECTRIC
Shorelines/Flood Hazard
Yes Not Applic. ❑
Plans Required 0
Received 0
WATER
PUBLIC ❑
PRIVATE 0
SEWAGE
SEPTIC ❑
SEWER 0
Ownership
Public ❑ Private 0
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 riot. The granting of a permit does not presume to give au-
thority 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
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROV LS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE _
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE')
23 Kw r ��
f'Rrace.ss/NCL,
//f
r JZoONL0 PC P1•)
l IV1M cJ/r
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOT $"RO,rri.)
PERMIT NUMBER
gelA
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEYSLEI� 4 - 8 4
PERMIT'N0.7' S 2 * 2000 �d7AL