HomeMy WebLinkAbout1983, 05-13 Permit: 83A-4029 Mechanical FixturesPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON Y SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
z
L, 0 *L p' 1
PERMITI ri ) n %�A
L
No. Baths
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
No. Fin. Rooms
STREET ADDRESS
TYPE 'NEW E] ALT. El AD'N. El RPL. El MVE.
PARCEL NO.
7. OF ❑ OTHER
CertifLofExempt.
Required Yes❑ NOD
Number
WORK ❑ BLD. ❑ PLMB. 1%VIECH. ❑ M.H. ❑ POOL
Lor
BLOCK
SUBDIVISION
DESCRIBE WORK
Shorelines/Flood Hazard
LEGAL DESCRIPTION:
2.
Yes❑ NotApplic. ❑
Received ❑
VALUATION
SOURCE
GA�S/
EL CTRIC
OWNER
PHONE
PHONE
FEES COLLECTED
9
I
LI
UTILITIES
X
PRIVATE El
3.
�16
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 type of
work will be complied with whether specified herein not. The granting of a permit does not presume to give au-
MAILINGADDRESS
thority to violate or cancel the provisions of any state or local law regulating construction or the performance
ZIP
ual Set Backs in Feetto:
SIGNATURE OF CATION
DATE�_.�3
Mech.—Ax—
OWNER OR AGENT
SPECIAL
North South East West
CONT CTOR
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
PRELIM.
FINAL
DATE
d00
Env. Health
Commercial ❑
4.
_ (}�F �-(
SEPA
Modular/
Planning
AD15RESS
ZIP
Type Const.
Occupancy
Sprinklered
Fire
Prevent.
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
Engineer
Utilities
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck Uncv. Deck
Fin. Basement Unfin. Basement
6.
VALIDAT
WHEN MACHINE FERMI
THIS BECOMES A PERMIT..
Plans
Exam.
PERMIT NUMBER
z
L, 0 *L p' 1
PERMITI ri ) n %�A
L
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE 'NEW E] ALT. El AD'N. El RPL. El MVE.
7. OF ❑ OTHER
CertifLofExempt.
Required Yes❑ NOD
Number
WORK ❑ BLD. ❑ PLMB. 1%VIECH. ❑ M.H. ❑ POOL
or Variance
Received Yes❑ NOD
DESCRIBE WORK
Shorelines/Flood Hazard
Plans Required ❑
8•
Yes❑ NotApplic. ❑
Received ❑
VALUATION
SOURCE
GA�S/
EL CTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9
I
LI
UTILITIES
X
PRIVATE El
SEWER 11
Public ❑ Private ❑
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 type of
work will be complied with whether specified herein not. The granting of a permit does not presume to give au-
Building
thority to violate or cancel the provisions of any state or local law regulating construction or the performance
of construction. SEE REVERS E FOR RE INSPECTIONS
Plumbing
SIGNATURE OF CATION
DATE�_.�3
Mech.—Ax—
OWNER OR AGENT
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM.
FINAL
DATE
d00
Env. Health
_ (}�F �-(
SEPA
Modular/
Planning
MFG.Home
Fire
Prevent.
Other (Specify)
Engineer
Utilities
TOTAL $ ==�
SEPA
PERMIT IS NONTRANSFERABLE
VALIDAT
WHEN MACHINE FERMI
THIS BECOMES A PERMIT..
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
I N 180 DAYS
i i{_ 1 3_ 5
DATE4lS3UED.L
Building��
Tech.
PERMIT NUMBER
z
L, 0 *L p' 1
PERMITI ri ) n %�A
L