1981, 01-12 Permit: 81A-0343 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
e
LOT BLO K
0611.1
SUBDIVISION
OWNER
c tA
3 �
ADDfjcESS
I\jJ � 1
4' ADDRESS
CONTR
el
kotAl
LEGAL DESCRIPTION - SEE ATTACHED
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ZIP
PHONE
ZIP
TO
Ef/NEW ❑ ALT. ❑,/ AD N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. IrJ' MECH. ❑ M.H. ❑ POOL
❑ OTHER
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
DESCRIBE WORK
8.
1'
VALUATION
9.
SOURCE
OF
UTILITIES
GAS ELEC RIC
WATER
SEWER
No. Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
Storage
Unfin. Basement
No. Stories No. Rooms No. of Dwellings
CERTIFICATE
of EXEMPTION
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
_4
DATE OF APPLICATION ' 6/ SIGNATURE OF APPLICANT foie_ ',w-1'\
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Recd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ��
PERMIT NUMBER
C4* *1600
*1600
342
01-12-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 11i2';
DATE ISSUED
3,43g *1600a -
PERMIT NO. TOTAL