1982, 04-19 Permit: 82A-2934 Piping, HeaterPLAN 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
1.
2.
3.
JOB ADDRESS
LOT
•
Be) LOC 7 S rUB VISTA
LEGAL DESCRIPTION - SEE ATTACHED
OW
ADC eSS
CONTR
4' ADDRESS
PHONE I %
PZHC
PARCEL NUMBER /S
Actual Set Backs in Feet
North 'South East (West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER
J. ADDRESS
PHONE
Valuation 1Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
r( NEW ❑ ALT. ❑ 'N. ❑ RPL. ❑ MVE.
❑ OTHER
❑ BLD. ❑ PLMB. di MECH. ❑ M.H. ❑ POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIB` — ►f E WO 117,
I ei yr
8. VALUATION
SOURCE GAS
OF
9. UTILITIES
LECT IC
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that 1 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 ,17//9/520.--.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT,f i�P' f•(.././ —�
SPECIAL CONDITIONS:
1101/4-T6.19-'' 617
P (i»)
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
17_
PERMIT NUMBER
5,A-z�3-
04' * 1 9.00
*19.00
*19.006
A *0.00
293.32
04 -19 -82
5_ 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04:19 " -'82 293,41 *19,0021
DATE ISSUED PERMIT NO. TOTAL