1986, 06-01 Permit App: 00011867 Gas 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 LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK .SUB ISION PARCEL NUMBER/S 065
11-3
+ rj
2.
OWNS PHONE
3. C :'a h 0 --
ADDRESS
- f It.,7
ADDRESSZIP Actual Set Backs in Feet
b1,4c� � 2 /f,
North South East West
COP4TRACTOR PHONE Size of Parcel Zone Cilassification
4.ADDRESST
UUT l t-N���
6- O�vrn��tirr �(J7 f 5u�
ADD ESS ZIP Type Const. Occupancy Sprinklered
r
❑Yes [—]No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE❑ NEW ALT. 1:1 AD -Nm (
No. Baths No. Stories No. Rooms No. of Dwellings
❑
7, OF RPL. ❑ MVE.' ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd- Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum, Dist. Location (Area)
$, FEES COLLECTED
�• VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF Ownership USE CODE
19. UTILITIES Public ❑ Private ❑ Single $
1 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 Building
to give authority to violate or cancel the provisions of any other state or local/tFA regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTAONS Plumbing
DATE OF APPLICATION I T i J 7`�JJ
S GNA URE OF APPLICA Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health ,
Planning
Fire Marshall
Co. Engineer.
Utilities
Plans Examiner
SEPA Checklist
Building Technician PERMIT IS NONTRANSFERABLE
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
i ! 4:2�-7
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.