1980, 09-10 Permit: M80-9964 Mechanical FixturesPLAN NUMBER
L
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 (509) 45636)5
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPI FS
1.
2.
3.
JOB ADDRESS
LOT LOCI I
CK' SUBDIVISION
OWNER rS � (6.,y\
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
PARCEL NUMBER/5
ADDRESS
S. 4 7- ! SC Qcu ,,,,,n....9 Ct
CONTRACTOR
4' ADDRESS
G, `i?o9 ice
ZIP
Actual Set Backs in Feet
North (South (East (West
PHONE
Size of Parcel 1 Zone Classification
ZutC12 u Co
Type Const.
Occupancy
Sprinklered
Oyes 0No 0 Req'd.
5.
DESIGNER
PHONE
Valuation I Building Aroa In 50. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Aroa
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
4X NEW
0 BLD.
O ALT. �0 AWN. 0 RPL. 0 MVE.
❑ PLMB. Cy MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. o1 Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. L . ,R,"—<. -U
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
xX
WATER
SEWER
Enum. Dist.
Location (Area)
Ownership
Public 0 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
ie4—L,_cdtmegotAili
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
ammng
Fire Marshall
Co. Engineer
UtIIItles
Plans Examine
SEPA Checklist
Building Technlcla
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
o_
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
c
n� I ERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
U•94.rif B 0'
DATE ISSUED
94U.4i
PERMIT NO.
't700Dac-i
TOTAL