1982, 11-03 Permit: 82B-0495 Mechanical FixturePLAN NUMBER
APPLICATION/ PERMIT
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SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO 615AK 'lll COPIES
JOB ADDRESS �,
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LEGAL DESCRIPTION —SEE ATTACHED
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LOT BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
OWNERPHONEY
/IJP�LjL
3.
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ADD SS
ZI
Required Set Backs in Feet
7 ! S�
North South
East West
CO RACTOR
Py NE
Size of Parcel
Zone Classification
,
4.
ADD
Z ^, /
Type Const.
Occupancy
Sprinklered
`)
/ I Y /
Com/)
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE 2 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OFE,/ ❑OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK 1:1 BLD. ❑ PLMB. 'C`J MECH: ElM.H. El POOL
of EXEMPTION
ESCRIBE WORK
8 AWA
s ,nom, / ): `C )PCU jH(�� FEES COLLECTED
VALUATION `(�' `Yv VSCource J!' U_ H6
ELECT LRVICN WATER SEWER
of
9, Utilities
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 thisBuilding
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 Io I law regulating construction or the
performance of construction.
Plumbing
DATE / L �(Jy SIGNATI
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities TOTAL $
Zone Clearance
WHEN MACHINE VALIDAT
SEPA Checklist THIS BECOMES A PERMIT.
DATE -6FFICIAL - I� 0 3" 8 2
APPROVED FOR ISSUANCE
PERMIT NUMBER
DATE
0
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THIS SPACE,
49.52 *20.00°
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THIS SPACE,
49.52 *20.00°