1980, 01-09 Permit: 80A-9959 Mechanical FixturesPLAN NUMBER
JOB ADDRESS
Source
of
utilities
LOT
LOC
2.
Zone Classification
OWNER
3. B R1ACE
ADDRESS
CO TRA TO
4. A I I lI
ADDRESS
DESI NER
5.
ADDRESS
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
e=, -7w LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION I PARCEL NUMBER/S
CHANGE OF USE FROM TO
6. - --
PHONE
ZI_P
PHONE
499-
IZ P
*Vl
PHONE
ZIP
I vrt X NEW ❑ ALT. �❑l AD'N. El RPL. 1:1MVE.
% El OTHER
WORK ❑ BLD. 1:1PLMB. bt MECH: ElM.H. EIPOOL
Required Set Backs in Feet
Source
of
utilities
North South
East West
Size of Parcel
Zone Classification
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
Type Const.
Occupancy
Sprinklered
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DATE SIGNATURE Mech.
DWL Area
Basement Area
Garage Area
Storage
Env. Health
SEPA
Split Entry
Split Level
Rancher
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
No. Baths
No. Floors
No. Rooms
I Rec. Room
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
CERTIFICATE
Req'd.
I Recd.
Not Rei
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
s. )&1s Lr- .;21. I ej49 Alt? HpI ►j' I L D� �
PEWVIIT) - NU�1BER
DATE
u4* *7,00
* ~
*7,00Y
E 1r. Q 1 0
995.8
01 -09-,30
6479.
VALUAI IUN
9.
Source
of
utilities
GAS
ELECTRIC
lC.
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
performance of construction. Plumbing
DATE SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTA L $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist (� THIS BECOMES A PERMIT.
—i74U'
i. 5
APPROVED FOR ISSUANCUE
*7.110 0 F'