1981, 09-22 Permit: 81A-9667 Mechanical FixturesNUMBER APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
%-1 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL gESCR4PTION — SEE ATTACHED
LOT BLOCK SUBDIVI ION PARCEL NUMBER/S
ADDRESS
,L /oz C'/S c
C NT.RAACCTOR /
4' ADDRESS
DESIGNER
5. ADDRESS
&I'—
L —
PHONE
ZIP
Actual Set Bi
North
PHONE
Size of Parcel
v2 �-
ZIP
Type Const.
y a�
PHONE
jValuWtion
ZIP I Main Floor
in Feet
Zone Classification
Occupancy Sprinklered
[--]yes [-]No ❑ Req'd.
Building Area in Sq. Ft.
Upper Floors I Garage Area I Storage
CHANGE OF USE FROM ITO I Area of Decks I Finished Basement I Unfin. Basement
s.
No. Baths No. Stories No. Rooms No. of Dwelling
TYPE El NEW ❑ALT. 1:1 AD -N. ❑ RPL. El MVE.
7, OF ❑ OTHER
WORK 1:1 BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑POOL CERTIFICATE Req'd. Recd. Not Req'd
of EXEMPTION
DESCRIBE WORK ` j �/ Enum. Dist. Location (Area)
8. .vj ref.- �f//A�IPK �/r FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. UTILITIES 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
performance of construction. SCREE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
/ATE OF APPLICATION / /t_ SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: 5K Uv
s , / ,vu�/� /� Plan Check
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify)
TOTAL $ l9,UCa
JPERIT,,�MBER,,_7-1
04* *19.00
*1 00
* 1 9.00
A *Ou0
966.6
09-22-81 -
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
093��2'2`-'8'1' 9+66.7 z
DATE ISSUED PERMIT NO.
*00a
.19 -J
TOTAL