1980, 11-20 Permit: 80B-4004 Water Heater11PLAN NUMBER
Sr -7C
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
LO- BL ictiDIVIS!N „t
2.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
OWNER
•ADDRESS
PHONE
CF. 4 S(.-- »-I 4.1 e co U t * S c I\NQ'a L3 k
ONTRA OR '
4. S\-1 4AiAT)NC ( oN11J'-,T1oNt\l-=
ADDRESS
, r
5.
DESIGNER
ZIP -
\c4c3.1 (4)
Actual Set Backs In Feet
North 'South
East
(West
PHONE
Lwt • `1 1
Size of Parcel
Zone Classification
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
.OVes 0No 0 Req'd.
Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK.- 0 BLD.
DESCRIBE WORK
k.
0 -NEW
TO
Area of Decks
Finished Basement
Unfin. Basement
0 ALT. 0 AD N.
0 PLMB. XMECH.
ii RPL. 0 MVE.
0 M.H. , 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. o Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Reed..
Not Req'd.
8. V�]ST?.. L AT . CS i.1
-kO GAt. QAS z (~vY:Frrcae.
VALUATION
9.
SOURCE
OF
UTILITIES
Xgx
ELECTRIC
1/41 WATER SEWER
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
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 state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
- DATE OF APPLICATION / 2 °/�2 SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ding Tec nician
Agi
t
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) 9' a
1,.o
TOTAL $ 9 . oci
Or7
PERMIT NUMBER
8)v ±irr
04* *9.00
*9.00 m
*9.006
A *000
400.32
1H-20-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'` Ili ¢2,0;»1801
DATE ISSUED ,
4'014 '5! • •9,00.0
TOTAL
PERMIT NO.