1981, 12-09 Permit: 81B-2579 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 ADO ESS
,. 24'L<2 -3 kg LA.) r,. % bre.
ALO — B OCK SUBDIVISION
2.
4.
OWNFR
/e. rti C/C //
AE7 72 Z /Lima,[- Aa —
It l-ieW'1'IGuc1 4
$3�x L1 It S 3
'pc et 20 2_
LLU -ci 16
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs In Feet
North 'South [East 'West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered_
❑Yes ❑No 0 Req'd.
5.
DESIGNER
-PHONE
Valuation I Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE 1/2 0 NEW
7. OF
WORK 0 BLD.
8.
❑ ALT. 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. L3'M ECH. 0 M.H. 0 POOL
DESCRIBE WORK S
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GA ELECTRIC
WATER
SEWER
Ownership
Public 0 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 construction or the
performance of construction. SEE REVERSESIDE FOR REQUIRED INSPECz�ONNNS
DATE OF APPLICATION I _ f ru ) 'SIGNATURE OF APPLICANT 1�--"" Wee—
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA'Checkhst
C Bu \ ecn
SPECIAL CONDITIONS:
ty e_,s—(—it d#4s lion ei . .
Nan c a c.ft w f f lh 11) e Ii c.) 14-.5 rev Merz
4 'zi; OCQ 76i LA,/
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 110 CP -
PERMIT NUMBER
g,115—���9
04* *1600
* 1600 '6
* 16006
A *0.00
257.82
12-09-81
2 647.9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1;,/,„1, i
a iI...io'9:- a,ia z 57..9z :1 6. o d
DATE ISSUED, PERMIT NO. TOTAL
.1
Y
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