1981, 01-12 Permit: M81A-0313 Mechanical FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS kL f 1�11-
LEGAL DESCRIPTION — SEE ATTACHED
LO1
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/5
OWNER � i1 -77a3 �0.
7 � ZC• t
ADDRESS
PHONE
ZIP
Actual Set Backs in Feet
North 'South East !West
4.
CONTRACTOR
PHONE
Sire of Parcel I Zone Classification
ADDRESS
Z -3o r.
Zil 2 0 Lip
Type Const.
Occupancy
Sprinklered
❑Yes ❑NO 0 Reced.
5.
DESIGNER
PHONE
Valuation Building Aroa In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Arca
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
7.
TYPE
OF
WORK
,NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB.--tMECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. q Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. .1a_ k.��
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
W -& 4 -c 4: st_cit_61jujr�
WER
ELECT RIC
.x x
WATER
Enum. Olst.
Location (Area)
Ownership
Public O 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 SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 12 _ 24— R'
— ic.0 SIGNATURE OF APPLICANT ` ) t�-�-�-t-,I IL-�'+✓`�'�c/e
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env
Planning
Co. Engineer
Utilities
sans Examiner
SE • A nitchiest
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Sngle $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specifyl
TOTAL
M
PERMIT AJMBER
-
34* *1400
*14.00 rn
*14000
A *Q00
31.22
01-12-81
3
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01=12-81
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
313= *1400 a. -
PERMIT NO. TOTAL