1982, 05-18 Permit: 82A-3877 Mechanical FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - i3UILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. 47/6
LOT
2.
BLOCK
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNER
3, rief,V K Cc
ADDRESS
/o/Uh 9e-1
PHONE
?'--
4.
5.
CONTRACTOR
A O X A) //64T14)6 y "Vd-
ADDRESS
-7/S 797,11rVSf/L40
DESIGNER
ZIP
?`7020 (:)
PHONE
�aD—a?6
Actual Set Backs in Feet
North 'South LEast (West
Size of Parcel 1 Zone Classification
ZIP
99ao4,
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor f Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
El NEW
❑ BLD.
DESCRIBE WORK
❑ ALT.
❑ PLMB.
❑ AD'N-
Q MECH.
O RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8. r/EAU 3 k: -J ueil t4C — 3 -IDA) X/,+T P c, D iec Twc2
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
'Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION -77 77/ P/ 8cx SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
g Tec'\nician
SPECIAL CONDITIONS:
I,CsRm I % /0 .
cro
FoRN. 5 o
A!I
Pc4/iP 4� Sri
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. //. erlD
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /c- %'D
PERMIT NUMBER
04* * 1 9.00
* 1 9.00 U)
* 19.006
A *0.00
387.6
05-18-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 =g'2 387.72 *19.00°
DATE ISSUED PERMIT NO. TOTAL