1980, 02-28 Permit: 80-1640 Water HeaterPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
LOT
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
3 /9 e -->L/1 “, ,E' L -74-/c
ADDRESS
CONTRACT
4. ADDR
ZIP
P99I4-
HO- -// 7d
PARCEL NUMBER/S
Required Set Backs in Feet
North (South
Size of Parcel
East
West
Zone Classification
DESIGNER
ADDRESS
,f &767
ZJ,P
Type Const.
Occupancy
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
TYPE
7, OF
WORK
9.
❑ NEW
❑ BLD.
DESCRIBE WORK
VALUATION
❑ ALT. 0 AD'N.
APLMB. 0 MECH:
❑ RPL.
❑ M.H.
❑ MVE.
o POOL
0 OTHER
Valuation
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
DWL Area I Basement Area
Split Entry
No. Baths
//te
Garage Area
Storage
Split Level
No. Floors
No. Rooms
CERTIFICATE
of EXEMPTION
Req'd.
Sour
of (J
Utilities
GAS
LE TRIC
WATER
SEWER
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.
DATE SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE E'1. -.g' DO
FFICIALQ.
APPROVED FOR ISSUANCE
Rancher
Rec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
(PERMIT NUMBER
10-1640
DATE
03* *550
* 5.50
* 5508
E *0,0C
163.9g
02-28-80
$ 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOM F MIT.
.2
021-.gA,-`P,8Ur 16402 *5.50°�