1983, 05-11 Permit: 83A-3944 Pool HeaterLAN NUMBER
APPZICA7rION/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 LEGAL DESCRIPTION — SEE ATTACHED
1. //0/%�
LOT I BLOCK [SUBDIVISION I PARCEL NUMBER/S
jOWNER
3. ,,o
RDDRESS
fi . //ca / 7
C NTRACTOR
4''(� DDRESS
C`.//6/6
DESIGNER
5. ADDRESS
PHONE
�'? 4�--369
ZIP
Actual Set Backs in Feet
/�
a� �'
No. Baths
No. Stories
orth South East West
PHONE
ize of Parcel
Zone Classification
9a -/ 8.9-3
ZIP
Type Const.
[Valuation
Occupancy
Sprinklered
9 3 of o 4
CERTIFICATE
Req'd.
❑Yes [-]No ❑ Req'd.
PHONE
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors I
Garage Area
F Storac
CHANGE OF USE FROM Area of Decks I Finished Basement I Unfin. Basement
6.
-.(,/L
(
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE 4. NEW
El ALT. 1-1 AD'N.
❑ RPL. 171 MVE,
7, OF
❑ BLD.
❑ PLMB. ❑ MECH.
❑ OTHER
❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
/
J
Enum. Dist.
Location (Area)
FEES COLLECTED
IX�, 0 e �Tll pew tG qL
VALUATION SOURCE GAS ELECTRIC W ER SEW Ownership USE CODE
OF
9. UTILITIES Public ❑Private ❑
Single $
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 Building
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 REVERSE SIDE FOR REQUIRED INSPECTIONS ®,�� Plumbing
nATF OF APPLICATION 43 SIGNATURE OF APPI ICANT 4e-+'•c'�"-"-' Mech. C
SPECIAL APPROVALS
f NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
ns Examiner
SPECIAL CONDITIONS:
�i
4r'nrz� es),
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ n. ea
PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 83 394,425
DATE ISSUED PERMIT NO.
*19,00ao
TOTAL