1981, 12-01 Permit: 81B-2291 Hot Water TankPLAN NUMBER .
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675'
JOB ADDRESS
LOT
2.
BLOCK
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
UB D Af ISI N
3. fStOC, �.
WN
ADDR S
I / i% Lie ee,t
CON RACTOR
«ti Seo 3
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
5.
DESIGNER
ZI
PH Ncc51J-
PHONE
Actual Set Backs in Feet
North 'South East (West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
Dyes ONo D Req'd.
Valuation I Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfln. Basement
O NEW
O BLD.
O ALT.
❑ PLMe.
DESCRIB WO•K
8. / %a/l� �C
VALUA ION SOUR S
OF
9. UTILITIES
AD'N. 0 RPL. 0 MVE.
MECH. 0 M.H. 0 POOL
ELECTRIC
WATER
0 OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public 0 Private 0
Location (Area)
USE CODE
Req'd.
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
to give authority to violate or cancel the provisions of any other sta'€ or local law regulating cons ion or the
performance of constructiioo , / SEE
/ REVERSE SIDE FOR REQUIRED S�fe•PEECTTIONS
DATE OF APPLICATION "" /' SIGNATURE EzcF-
SPECIAL APPROVALS
NAME DATE
Env. Health
ammng
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu hn V
SPECIAL CONDITIONS:
.30?,ODJ aQi'"CC
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
eiti
Mech. /`�
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
%k t3 —Zag(
04* *1600
* 1600
* 1600'6
A *0.00 8
229.'0f4
11 2 X01 —81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
r•
'1'21;'0,),) d]:
DATE'ISSUEO ' PERMIT NO. TOTAL
2129,1= *16.:OK0a(i
0-
O
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