1980, 01-31 Permit: 80-748 Mechanical FixturesPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
110 .35- LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
Source
of
U tilities
GAS ELECTRIC
N X
WATER
SEWER
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
OWNEPHONE
� qeD EN
Building
>.&- Y.;t
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
3.
Plumbing
performance of construction.
DATE SIGNATURE _
Mech.
ADDRESSfy�
ZIP�/�
/ry
Required Set Backs in Feet
Env. Health
iE. ��J a �G�i�/��
SEPA
7.21L
North South
East West
Mobile Home
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
-/ c-
'i�'l -�.5'
4'
ADDRESS
Gj
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL 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 NEW ❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
7,
OF
❑ BLD. ❑ PLMB. XMECH: ❑ M.H.
❑ OTHER
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
8.
DESCRIBE WORK
/
..�N a T �1.. L.. A l� T714N.��.L-.I� r�' I � u��
't
X" u C:`f LU L1 �'K
FEES COLLECTED
VALUATION
Q,
Source
of
U tilities
GAS ELECTRIC
N X
WATER
SEWER
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
Plumbing
performance of construction.
DATE SIGNATURE _
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Plan Check
Env. Health
f
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
F+ERMIT NUMBER
4 M I $o -�
DATE
04* *7.00
*7,0C
*7.00
0, or,
74.7
01-31 -8C
6.479,
Utilities TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIP PECOMES A PERMIT.
1_ J.,Ipp nnO
DATE 1--Kj-2DOFFICIAL—" 1AA&AWLS.— E
APPROVED FOR ISSUANCE