1980, 09-04 Permit: 80-9569 Water HeaterPLAN NUMBER
V
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
1.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
PP
LOT SUBDIIVIONA
2.
OWNE
3.•Ali �/?!F,/n
ADDDFrSS
�CTOR
6e)
4. R ���7`7
irk 870 %
DESIGNER
CON
BLOCK
5.
•
?(Q67.
PH
PH NNEE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
n J 0 l -f)
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel , I Zone Classification
PHONE
Type Const.
Occupancy Sprinklered
❑Ves ❑No ❑ Req'd.
Valuation . Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
8.
9.
TO
Area of Decks
Finished Basement
Unfits. Basement
❑ NEW
❑ BLO.
❑ ALT. 0 AD N. 0 RPL. ❑ MVE.
1�S'GLMB. 0 MECH. 0 M.H. 0 POOL
SD URGE
OF
UTILITIES
GAS
EL
F.CT1RIC
WATER
❑ OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
Req'd.
I hereby certify that 1 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
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ung Tec tnician
SPECIAL CONDITIONS:
. PERMIT IS NONTRANSFERABLE
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
/6U
SEPA
Mobile Horne
Other (Specify)
TOTAL $ —
PERMIT NUMBER
- 9-569
04* *550
*55p N
*5506
E *0.00 8
95682
09-04-80
2 6479,
•
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
b19 �i0!�U' 8y'0' 915 6, 9:5 d* 5.5 0 c°.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL