HomeMy WebLinkAbout1980, 01-09 Permit: 80A-9955 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
E. %fog
LOT BLOCK
36,
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
OWNER
3. C i? ft'ly tDnl� (
ADDRESS
E'lOib 44 P -''------
CONTRACTOR
4. 44 fit,qr-/AJC'- 41 /► ll/c,00.17
ADDRESS
D ESE R
5' ADDRESS
PHONE
9,x.4
ZIP
9r99cVe3
PHONE
z9
A
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
East 'West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
Lives ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
NEW
❑ BLD.
❑ ALT.
D PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
AIek
STALL /IVALUATIONt) �� • � Source AIR Hi!/V /,/ �ELECTRIC•` 'O WATER
of
(S E
9. Utilities
SEWER
I 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 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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7.6e,
PERMIT i%UMBEP
ckck
DATE
04* *7.00
* 7, '.J i) J
* 7,00u.
E -1000
9954_
01-C9-30
6479,
DATE I_Q`-"O
. "FFICIAL 51A,_IPA. iii_
1 APPROVED FOR ISSUANCE
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
3