1980, 04-02 Permit: 80-3008 Mechanical FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
� _ I � , ' ,
8. Aj t i CKK
FEES COLLECTED
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
Source
JOB ADDRESS
N
-
SEWER
LEGAL DESCRIPTION —SEE ATTACHED
1.
ice,c7
_
LOT
BL CK
SUBDIVISION
PARCEL NUMBER/S
2.
I
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
OWNER
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
PHONE
Plumbing
perform1a�nce of construction.
DATE '''Z` 11 SIGNATURE—
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
3
ADDRESS
Plan Check
Env. Health
ZIP
Required Set Backs in Feet
SEPA
Q,_ �r
p
,�L} / �/
3J
99,.�3
North South
East West
Co. Engineer
CONTRACTOR
Utilities
r
PHONE
Size of Parcel
Zone Classification
-% re CG�10 ,
9. -41)i�-'/
SEPA Checklist v
U //l u -
4.
ADDRESS
APPROVED FOR ISSUANCE
ZIP
Type Const.
Occupancy
Sprinklered
E
— LE=.
�
L� L.�d
❑Yes ❑No ❑ Req'd.
DESI NER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
DWL Area
Basement Area
Garage Ar;77
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`
E] BLD.
❑ PLMB. 9 MECH: ❑ M.H.
ElOTHER
❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
� _ I � , ' ,
8. Aj t i CKK
FEES COLLECTED
VALUATION
Source
GAS ELECTRIC
WATER
SEWER
of
9,
Utilities
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
perform1a�nce of construction.
DATE '''Z` 11 SIGNATURE—
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
r
TOTAL $
Zone Clearance
WHEN MACHINE VALIDAI
THIS;BECOMES A PERMIT.
SEPA Checklist v
U //l u -
DATE OFFICIAL �� �r—' a� 1a
al
APPROVED FOR ISSUANCE
PEIRMIT NUMBER
oo
DATE 15
04* *7.00
*7,G0
*7,00
F *0,OG
3007
04-02-80
6479.
s
HIS SPACE,
1, a