1980, 07-07 Permit: 80-6700 Water HeaterAPPLICATION/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
BLOCK
SUBDIVISION
2.
OWNER r
3 rY . K L'. 4tY Q i l
ADDRESS
CONTRACTOR
4. \.t -Z -`A3 ileCttL
ADDR
DESIGNER
5. ADDRESS
13( 10N E
ZI P
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
Size of Parcel
East 'West
Zone Classification
PHONE
ZIP
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Main Floor
Upper Floors 1 Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
ZAD N. ❑ RPL.
MECH. ❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
-LC ho-( -fer kra.or
ELECTRIC
WATER
Enum, Dist, I Location (Area)
SEWER
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
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS 1 SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
in c ician
FOR GAS APPLIANCES
PIPE SIZES
PIPE LENGTHS
BTUS
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
W
Plan Check c
SEPA
Mobile Home
Other (Specify)
TOTAL $ qt co
PERMIT NUMBER
Cy- -90 - (p100
04* *9.00
*9.00 tz
*9.006
E *Q00 8
669.9B
07-07-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 7. 0 7, - 81'0
DATE ISSUED
670,0°
PERMIT NO.
*9,00°
TOTAL