1984, 03-22 Permit: 84A-2501 Water HeaterNUMBER APPLICATION/PERMIT
PERMIT NUMBER
(PLAN
I SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESSPARCEL NO.
1. JEE' I > 9 / R (S h:- lv ✓ E l,tJ C )C i r-
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
I
OWN RON
1G�' Gi %fZta-411
1.f 710
PHONE
3.
(LING ADDR SS ZIP Actual Set Backs in Feet to:
Uj 4. North South East
West
CO TRACTOR /� c LICENSE EXPIRES PHONE / Size of Parcel Zone Classif !cation Residential ❑
�a L%— a� 1¢ D Commercial ❑
n MG / I v 2 , 21— ��— ice/
4
Ap'DDRESS /� / ZIP Type Const. Occupancy
�7"O
Sprinklered
❑No ❑Req'd.
,Y. 2. Li1�i�1Ll &V O � 9.1-0❑Yes
DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area
5.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncw. Deck
Fin. Basement Unfin. Basement
6.
No. Batas Na. Floors
No. Fin. Rooms No. Dwellings
TYPE El NEW El ALT. El AWN. ` RPL. El MVE.
7. OF ❑OTHER
WORK ❑ BLD. ❑ PLMB.gMECH. ElM.H. ❑ POOL CertifI.ofExempt. Required
Yes❑ No❑ Number
or Variance Received
Yes ❑ No ❑
DESCRIBE WORK/ Shorelines/Flood Hazard
8. �tQ
Plans Required ❑
��I C 3Q Yes❑ Not Applic. ❑
Received ❑
VA UATIDN SOURCE GA ELECTRIC WATER SEWAGE Ownership
d OF PUBLIC ❑ SEPTIC ❑
FEES COLLECTED
9. UTILITIES PRIVATE ❑ SEWER ❑ public ❑Private ❑
hereby certify that 1 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 au-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOJR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION �r —
00
OWNER OR AGENT DATE J
Mech.`
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
C
Prevent.
C
Engineer
Other (Specify) C
u
Utilities
�
2L�
TOTAL $
SEPA
MACHINE IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE
HEIS BECOMES A PERM TTED
Exam' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building �� IN 180 DAYS
Tech.
r.
2 — 8� 4
DAT�Sl1E� PERMI AL
�§• Q, 1 z * 2 0. D 0