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1980, 12-30 Permit: M80B-5295 Mechanical Fixtures
(PLAN NUMBER lv� 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 JOB ADDRESS 1. E. f o LOT 1 BLOCK 2. SUBDIVISION 3. OWNER STI/vt. 12)sE ADDRESS P. 0. 13 0) J33 ci CONTRACTOR PHONE ZIP /�j It{� LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S Actual Set Backs in Feet North (South East (West 4. ,4 Des S ©A) 5 //'TT ADDRESS f3 /S 'l1/9/U�"P/OLID DESIGNER 5. PHONE Size of Parcel 1 Zone Classification ZIP Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. PHONE Valuation (Building Area in Sq. Ft. ADDRESS ZIP Main Floor Upper Floors 1 Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK Ed NEW ❑ ALT. E AD'N. ❑ BLD. ❑ PLMB.'MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK 8. 6 c re, C VALUATION 9. Enum. Dist. FUee/U . 0u c T - w 0.8 k Location (Area) SOURCE OF UTILITIES GAS ELECTRIC WATER SEWER 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 /2w� Z} SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE PFRMIT FYPIRFR ANF VFAR FRrIM r)ATF (1F ISSI IAnirp FEES COLLECTED Single $ Building Plumbing Mech. ,V Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 7 PERMIT NUMBER "), - 7� 177 04* *7.00 *7.00 to - *7.006 A *0.00 529,42 12-30-80 2 6,479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 12.-30=8'0' I,ATir- ,r', r-;-• 529.52 *7.00CL Q