1983, 01-20 Permit: 83A-0504 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 ADDRESS
LOT
2.
/
•C ✓VIS ON (\ e.(} ril_e41I IL
BLOC II dI
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER .% /% 0.
,j
3 ' \�-1't5`
ADORES()
/ U ` &' ay/
CONTR,CTOR f
'A P+tir 4 CcSL
4.
5.
RC1
PHONE J
;)6?L cie
PHONE/d-6,-ie
A OTtESS
DESIGNER
ZI )
PHONE
ADDRESS
ZIP
Actual Set Backs in Feet
North !SouthEast (West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklereo
❑Ves ❑No 0 Req'o.
Valuation Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE Sty„EW
7. OF
WORK LD.
❑ ALT. 0 AD N. 0 RPL. ❑ MVE.
❑ PLMB. ff-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.
7----
DESCRIB,E WORK
8.
SOUR
9. UTILITIES
VALUATION
GAS ,
ELECTRIC
WATER
Enum. Dist.
Location (Area)
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 gra ting of a pe, mit does not presume
to give authority to violate or cancel the provisions of any other state or !die I law regulatijig constru5t'on or the
performance. of construction. SEE REVERSE SIDE FOR REQUIRED INSPE IONS
DATE OF APPLICATION /I /�� SIGNATURE OF APPLIC4N // '/- "L"� ���%'r<�
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ui. •; Tete.
i
SPECIAL CONDITIONS:
rJOI) Si t s
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 $ �� 1
(hi
PERMIT NUMBER
egur _oso4-
0a *1600
*16006 -
A *000 8
503`
0'1 �20-83
61179.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
�7 tI�1� S. ')kk,,(
oi'llal!L i:0'.17 8!i71
DATE ISSUED
'50;42 *1.600.a�.
PERMIT NO. TOTAL