1983, 04-13 Permit: 83A-2894 Mechanical FixturesPLAN NUMBER APPLICATION/ PERMIT IPERMIT NUMB�ERc�-�
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
❑ NEW ❑ALT. ❑ AD'N. �F2PL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ElPLMB. MECH. ❑ M.H. El POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
D,jCRI E WORK Enum. Dist. Location (Area)
/ A y�
8.
VA rUATION I Sb6RCE ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑Private ❑
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 re ulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
> � 9
DATE OF APPLICATION /� SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) / -
TOTA L $ V
04* *16.00
* 1 6, 0 010'
A *0.00CD
289,3<
04-13-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04+1'3,-8`3' 289,42
DATE ISSUED PERMIT NO.
TOTAL
APPLICANT:
COMPLETE NUMBERED SPACES -
PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
- T4
LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK
SU DIVISION
PARCEL NUMBER/S
Z.
I
3.
OWN
- p
PHONE
ADDRESS �
sJ
—�
_
Z `` /+ �
Actual Set Backs in Feet
North South East West
4.
CONITRACTOR
PHNE
Size of Parcel
Zone Classification
ADDRESS
i
ZIP
Type Const.
Occupancy
I
Sprinklered
Dyes ❑No ❑ Req'd.
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 ❑ALT. ❑ AD'N. �F2PL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ElPLMB. MECH. ❑ M.H. El POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
D,jCRI E WORK Enum. Dist. Location (Area)
/ A y�
8.
VA rUATION I Sb6RCE ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑Private ❑
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 re ulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
> � 9
DATE OF APPLICATION /� SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) / -
TOTA L $ V
04* *16.00
* 1 6, 0 010'
A *0.00CD
289,3<
04-13-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04+1'3,-8`3' 289,42
DATE ISSUED PERMIT NO.
TOTAL