1987, 11-02 Permit App 87003743 ResidenceSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
NORTH 811 JEFFERSON
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct. In
addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE provisions included herein and agree to comply with same. All provisions of laws and
ordinances governing this type of work wit be complied with whether specified herein or not. I understand that the issuance of this permit and any subsequent inspection
approvals or Certificates of Occupancy shall not be construed to give authority to violate or cancel the provisions of any state or local law regulating construction, or as a
warranty of conformance with the provisions of any state or local laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
:ma-
rs LAC
tl.
3191
* INFORMATION WORKSHEET
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* ,.//70Z
* PARCEL NUMBER: I i(5l/L z "�
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* STREET ADDRESS: l o 7
* CITY/STATE/ZIP: 6 ()) ! ? 37
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* SUBDIVISION: '([11-1-ikreD r S
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* BLOCK: / LOT: ZONE: SP:I' DISTRICT:
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* LOT AREA: F/A: WIDTH: -Mr DEPTH: /i R/W: 46,011)
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.B:MILDING INFORMATION
# OF BUILDINGS: f
# OF DWELLINGS:
OWNER: �� � ex• C--e, L1.,5 PHONE: 6z7
MAILING ADDRESS: 1-_ /(e07. Sit yi 3
CITY/STATE/ZIP: L) e c 1. ? : /
CONTACT : -_ ; PHONE:
SETBACKS - FRONT: ,YS- LEFT: /er RIGHT: 2 --REAR: 93
PERMIT USE: S I Dom(?
* CONTRACTOR LICENSE NO.: f)3].7 Cj 1 / �3 /
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* CONTRACTOR: �� A S PHONE:
* MAILING ADDRESS: A
Z-0----V1
* ARCHITECT/ENGINEER: PHONE:
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* MAILING ADDRESS:
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* NEW: > REMODEL: ADDITION: CHANGE OF USE:
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* :DWELL UNITS: /. OCCUPANT LOAD: BUILDING HGT: .STORIES:
* BUILDING DIMENSIONS:
*
X . (WIDTH X DEPTH) SQ. FT. /OE % *
*REGUIRED PARKING: 1 HANDICAP: SEWER:(Y/N): HYDRANT.
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CONTR LIC#:
CONTRACTCR:
MECHANICAL INFCRMATICN
MAILING ACCFESS:
CONTR LICA:
CONTRACT GR:
FFCNE: -
MAILING ACCKESS:
ELECTRIC:_ CAS:___ CIL:___ CCAL:_ ICGD:___ SCLAR:___ FEAT
MECHANICAL FEES PLUMBING FEES.
ITEM DESCRIPTION
NLHBER CF
ROCESSING FEE YES OR NG
®UCTWORK SYSTEM A-ZP
-OCCSTCVE/INSERT
AS WATER HEATER •
AS HTG EQUIP<10C.000>8TU
'AS hTG EOUIP+lOO,000 BTU
AS PIPING # OF UNITS
'EATPUMP 1-10nM BTU
IEATPUMP 101-500H BTU
EATPUMP 501-1,000M BTU
EATPUMP 1,001-1750N BTU
EATPUMP +1,750M BTU
EFRIG 1-100H BTU
`EFRIG 101-500H BTU
EFRIG 501-1,000M BTU
CEFRIG 1.001-1,750M BTU
EFRIG +1,750M BTU
IR CONDITIONER 0-3 HP
IR CONCITICNER 3-15 6P
IR CONDITIONER 15-3C HP
IP. CCNC.ITICNER 30-50 HP
IR CONOITLGNER 450 HP
ENTILATING FANS
VAPORATIVE CCOLERS
CODS
LOTFES DRYER
ANGE
AS LOG
NLISTED GAS APPLIANCE
IR HANDLER 1-10000 CFM
IR HANDLER 100004 CFM
ITEM DESCRIPTION
PROCESSING FEE
TOILETS
SINKS
SHOWERS
BATH TUBS
KITCHEN SINKS
DISH WASHERS
GARBAGE OISPCSAL
CLOTHES hASHER
UTILITY SINKS
ELECTRIC LATER HEATERS
FLOOR DRAINS
FLOCK SINKS
BAR SINKS
ROOF CRAINS
LAWN SPRINKLER
SEWAGE EJECTOR
WATER SOFTENER
URNAL
ORINKING FOUNTIAN
*
*
NUMBER OF
YES 0R LNC