1981, 06-26 Permit: 81A-6366 Water HeaterPLAN NUMBER
0.2
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 l'
1. «/'N 4 otG(24 _
2.
LOT (BLOCK
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISI
PARCEL NUMBER/S
OWNER
3 ADDRESS
S' L --
CONTRACT
4 /ADDRESS
7A
DE9IGNE0 a L 33
5.
PHONE
ZIP
Actual Set Backs In Feet
North !South East (West
PHONEO
Yarn
ZIP
Wio 7
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors ' Garage Area
Storage
CHANGE OF -USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE 0 NEW
7. OF
• BLD.
WORK
,➢CI ALT. 0 AD N. 0 RPL. 0 MVE.
,❑` PLMB. %MECH. ❑ M.H. ❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. !"s-;11-21 /J 4,4 Q A-1-4 'Yb Al t4
rut 74.2ta
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF.
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private ❑
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 %-5�+ SIGNATURE OF APPLICANT 51r- cirralieti
SPECIAL APPROVALS
NAME •DATE
Env. Health
Planning
Fire Marshall
Co
Enginee
Utilities
Plans Examiner
SEPA Check!
acigasa
SPECIAL CONDITIONS:
irrit
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
i'r/TOTAL $ Ari
1
PERMIT NUMBER
S, iA-E1.3&@
04* *1800
*1800
* 1 8 0 0 cY
A *0.00 3
63658
,06-26-8-1
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
636,'61 *'1.8.00
PERMIT NO. TOTAL
>-
0-
0 a0
U
LA -