1982, 09-14 Permit: 82A-8217 Mechanical Fixtures PLAN NUMBER APPLICATION/PERMIT y PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT ' lb-Z % '
7) NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 02-1-1V APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS rLEGA. DESCRIPTION - SEE ATTACHED L` 4. * * 1 0 0
1. 10716 E 21ST AVENUE
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNER DEAN JACKSON PHONE * 1 4,0 0
3. 926-5767 A * Q O
ADDRESS ZIP Actual Set Backs in Feet
10 716 E 21ST AVE. SPOKANE 99206 North 'SouthEast West ?'. 2 1. 6 <'
CONTRACTOR PHONE Size of Parcel Zone Classification
CAP HEATING 922-1539 U 9- 1 3-82
4' ADDRESS ZIP Type Const. Occupancy Sprinklered _
c/o E9514 Montgomery #23 99206 ❑Yes ❑No ❑ Req'd. <,479:
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
❑ NEW 0 ALT. A N. 0 RPL. 0 MVE.
7, OF �f 0 OTHER -
WORK
0 BLD. 0 PLMB. iLJ MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION s
DESCRIBE WORK Enum. Dist. I Location (Area) FEES COLLECTED
8. INSTALL SAVE FUEL DAMPER 6 BRAIN I " -
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES X Public CI Private CISingle $ 1(I 00 7
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 regu ating constr ctio ,,,or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
f
��//�DATE OF APPLICATION . %,,,«(SIGNATURE OF APPLICANT / / Mech.
SPECIAL APPROV' S / SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA a}.
Planning O
U
Mobile Home w
Fire Marshall _.i
U..
Co. Engineer Other (Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
:midi/ ecp s PERMIT IS NONTRANSFERABLE , . 0 9 -14-82 82175 * 14.00U
/4, ?' ' i PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL