1980, 09-15 Permit: G80B-0173 Mechanical FixturesFLAN NUMBER APPLICATION/PERMIT, PERMIT NUMBER
rn SPOKANE COUNTY - BUILDING CODES DEPARTMENT 166 0/
1 l�� NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1 JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
2.
OWN E PHONE.
�A —2s7c-,
3.
ADD SS/
ZI/P� r
Actual Set Backs in Feet
1-2:20 (� /
j�f�
North South East
West
CONT RAC OR �^
PHONE
Size of Parcel Zone Classification
_.0
4. ADDR
Z
Type Const.
Occupancy
Sprinklered
z
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
I Upper Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE ❑ NEW El ALT. El AD'N. ❑ RPL. 1:1 MVE.
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK —4—N1ECH.
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist. Location (Area)
FEES COLLECTED
8.
VALUATION
SOURCEI
t
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
UTILOITIES
Public []Private ❑
Single $
1 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 regulating construction or the
I
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
nATC /1C ADDI I(`ATI(lAI Cl/"KIATI IOC nC ADDI I( AItIT
Mech. /
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
PERMIT IS NONTRANSFERABLE
DCOIIAIT OVDIDCC nnlC VCAO CDf1AA nATF (19: ICCI IAIU(`G
Plan Check
SEPA
04* *9.00
*9.00
*9,006)
*0.00
17,22
09-15-80
6.479,
Mobile Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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