1980, 12-15 Permit: 80B-5016 Hot Water TankAPPLICA 1 KM/ rtrsmi 1
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
/$D / 07 (J e,2C eE/-742
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
LJWI n rn
a c A) A id
ADDRESS- (oC�/v/
4S/e //�% e/�
CONTR•. TOR
(00
4.
5.
A
DESIGNER
ADDRESS
520'7
P ONE
a��oas'
Actual Set Backs in Feet
North 'South
East
West
PH99NE
-5929 // 7C)
ZIP
49'Jaad
PHONE
Size of Parcel
Type Const.
Valuation
Occupancy
Zone Classification
Sprinklered
❑Yes DNo 0 Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
)EW
❑ BLD.
0 ALT.
0 AD N.
PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
❑ OTHER
No. Baths
No, Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. /1%5J,9- 6/ A6 A /) e4'Tt,e f,4,()t
VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF
9. UTILITIES
Enum. Dist.
Location (Area)
Ownership
Public D Private 0
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 c. struction or the
performance of construction. SEE • EVERSE SIDE FOR REQUIRED INSPECT' IJ S
DATE OF APPLICATION
SIGNATURE OF APPLICA
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Check!
ing Tech
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing ��od
LMech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
03* *500
*500
*5006
A *0.00
501,52
12-1'8-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.5101:6'
DATE ISSUED PERMIT NO.
*50021 -
TOTAL