1981, 07-01 Permit: 81A-6579 Pool 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
1. s a7/6 D,$4rn'CP f
N+eA AC/
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3
OWN31.
p b X /? .'.
PHONE
y26 -3 y60
PARCEL NUMBER/S.t(! .54'4'— 90/7
•
ADDRESS
9/5- 47,3 tiers sly /Q.4
ZIP
ypao6
Actual Set Backs In Feet
North (South
East
IWest
CONTRACTORy
4. $y nP f ✓C /3o
ADDRESS 7/cf • 27eea/Lr-
PHONE
989-714r
Size of Parcel
Zone Classification '
5.
DESIGNER
ADDRESS
jginC
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
Dyes DNo 0 Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
L7 NEW 0 ALT.
0 BLD. 0 PLMB.
0 AD N. 0 RPL. 0 MVE.
0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. Czo,ni Mi n4 /,c X A4/9 tc — ,9,26-0,00 BTU
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
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 1/3 0/en SIGNATURE OF, APPLICAN
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
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL
/7
$ /7
PERMIT-AUMBER'G
e[ .(p"1
04* *17.00
*17.00
`*17.006
A *000 0
657.8
07-01'-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ti I
Ah.!,
y'ioiit_ 8111.
65792 *1.7.00Da,�
--DATE ISSUED PERMIT NO. TOTAL
›-
(-1 U
W