1983, 05-12 Permit: 83A-3979 Mechanical FixturesLAN 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 3 COPIES
JOB ADDRESS
1. E. 10113 39th Ave. Spokane, WA. 206 LEGAL DESCRIPTION —SEE ATTACHED
LOT BLOCK SUBDI I.
PARCEL NUMBER/S
OWNER
PHONE
3 John Ellis
924-7768
ADDRESS
ZIP
Actual Set Backs in Feet
S. 4126 Sunderland Rd
North South East west
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
Custom Heating Co.
922-3315
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
S. 421 Dishman Mica Rd.
99206
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM TO Area of Decks I Finished Basement Unfin. Basement
s.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
®NEW ❑ALT. ❑ AD
'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. ®MECH. ❑ M.H. El CERTIFICATE
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
8. Install Elec. furnace, heat pump It ductwork. FEES COLLECTED
VALUATION1 SOURCE I GAS ELECTRIC I WATER I SEWER Ownership USE CODE
9. 3 800.0 UTILOITIES XXX Public ❑Private ❑ 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. SEE REVERSE SIDE FOR REQUIRED INSPECTIO Plumbing
DATE OF APPLICATION 5-9-83 SIGNATURE OF APPLICANT_ 1 Mech.
SPECIAL APPROVALS
NAME DATE
nv. Health
anning
ire Marshall
o. Engineer
tilities
lans Examiner
EPA Checklist
ng T chn1 a
i
SPECIAL CONDITIONS:
V
I
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $- �2
PERMIT NUMBER
e -3
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
05-12-83 39Z925
DATE ISSUED PERMIT NO.
i9 Gn' 0
* 1 4.001
.-
1 2—? 3
4 7 9.
*19.00IL -
TOTAL
a
CD
W
C