1984, 04-02 Permit: 84A-2825 Mechanical FixturesPLAN NUMBER APPLICATION /PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS N PAPrEL NO.
2 BLOCK susolvls A-tZiA D e LEGAL DESCRIPTION:
to,
OWNERP
ON
PHONE
GJ>fi
`� --5Z!
3.
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
"' '50 a
North South East
West
CONTRACTO OO f . j `
LLj
LICENSE EXPIRES
P
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4.
ADDSSD Aw`�
f T'v
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage I Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
TYPE �IEW ❑ALT. El AD'N. 1:1 RPL. ❑ MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7. OF ❑OTHER
WORK El BLD. ❑PLMB.�"MECH. ❑ M.H. ❑POOL
Certifi. of Exempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes ❑ No El
DESCRIBE WORK
8•
Shorelines/ Flood Hazard
Plans Required ❑
Yes❑ Not Applic. El
Received ❑
VALUATION
9•
SOOFCE
GAS
ELECTRIC
WATER PUBLIC ElSEPT
C El
1
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
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 compiled with whether specified herein or not. The granting of a permit does not resume to
p p g g p p give au-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning 7
Fire
Prevent.
Engineer S d
Utilities U i'
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech. . �.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMITNUMBER
a"e
TOTAL $
121
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUEDO 2 8�4 PERMIT�O. 2' z
5 c3
*23.00°'
TOTAL