1981, 03-04 Permit: 81A-2023 Water 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
JOB ADDRESS
1.
LOT
2.
d rP-
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK
SUBDIVISION
3.
OWNE
ADDRESS
iI J•
PHONE
'2c*'c /
PARCEL NUMBER/S
Actual Set BacksIin Feet
North !South
East
'West
4.
CON RACTOR
-La Li? —
DESIGNER
5. ADDRESS
PHONE
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ZI P
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Until'. Basement
TYPE
7. OF
WORK
8.
9.
NEW
❑ BLD.
DESCRIBE WORK
VALUATION
❑ ALT. ❑ AD'N. 0 RPL.
G ,LMB. 0 MECH. 0 M.H.
SOURCE
OF
UTILITIES
GAS
ELECTRIC -1-
WATER
0 MVE.
0 54.4'ej/
0 OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public 0 Private 0
Location (Area)
USE CODE
Req'd.
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 w regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT �NS
DATE OF APPLICATION
SIGNATURE OF APPLIC
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning P
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
LI Te h ian
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Rec'd,
Not Req'd.
FEES COLLECTED
Single $
Building
9(g).
Plumbing
Mech,
Plan Check
SEPA
Mobile Home
Other (Specify/
TOTAL $ 19—
PERMIT NUMBER
03* *9.0.0
*900
*9.006
A *0.00
202.2
03-04-81
679.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT,
03rr'0i4 -E 1
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
202'3' *9.002
PERMIT NO.