1980, 12-08 Permit: 80B-4552 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.
JOB ADDRESS
2.
LOT
BLOCK
SUB [JV SIGN e. b)i-? c L .) /A)
LEGAL DESCRIPTION — SEE ATTACHED
3. OWNEF � it)OUL/ /L\ Cs / `� G� ,S.
ADDREyS T �LI 09 /0/601 J
CONT CTOR - �: / /j/r 494 Aro 4. A DR C/. J ---3'7 27
DESIGNER
PHONE
/6,
PARCEL NUMBER /S
ZI ;? ,6
Actual Set Backs in Feet
North 'South
East (West
PHONF�p7' 7�
// 76
Size of Parcel
Zone Classification
Type Const.
Occupancy
PHONE
Valuation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
5' ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
PERMIT NUMBER
6oB—
04* *9.00
*9.00 to-
*9006
A *000 8
455.12
12 -08 -80
2 6.479.
Storage —
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
CSJ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. \ ECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE5K�
8. ��
VALUATION
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
9.
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 regulatin construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTI t S
r
/d
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
SIGNATURE OF APPLICAN
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buil
nician
SPECIAL CONDITIONS:
U ®d
tiSc 1 zt VN
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 $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12,-088`0
DATE ISSUED
455.22 *9.00a-J
PERMIT NO. %`E?I