1982, 06-21 Permit: 82A-5156 Water HeaterPLAN NUMBER
(°)
APPLICATION/PERMIT
SPOKANE COUNTY - BUItDW&G CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
JOB ADDR 5
33P � (.)-)0C)
LO
BLOCK
SJBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
3
4.
OWNER
ADDRESS
r
ToRi� cr('LL lI s,>? ( p
ADDRES7QS20 5 fie SPlP/4k_
DESIGNER
PHONE
5' ADDRESS
ZIP'-yy—/J��/
a:4 / G LW/1%�
ZIP
PHONE
Actual Set Backs in Feet
North (South East 'West
Size of Parcel 1 Zone Classification
Type Const,
Occupancy
Sprinklered
❑Ves ❑No ❑ Req'd.
Valuation 1 Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ Ay: 0 AD N. 0 RPL. 0 MVE.
PLM B.
0 MECH. 0 M.H. ❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
RIBE WORK
SOURCE
OF
UTILITIES
V-F�\ C/w
WATER
ELECTRIC
SEWER
Enum. Dist.
Location (Area)
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 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 —f? SIGNATURE OF APPLICANT 4.30 /(/ 1.
SPECIAL APPROVALS SPECIAL CONDITIONS: ..443 �,w
- VVV
NAME DATE `�"..
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checkbst
Bu
Ing ye chniclan
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
• FEES COLLECTED
Single $
Building
Plumbing
Mech. 4112'ty
heck
SEPA
Mobile -Home
Other (Specify)
TOTAL- $ « '0f)
PERMIT NUMBER
^�1SG
04* *1600
*1600
A *000 0
51554
.06-21'-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0l1614:21i1'14*8'2;
DATE ISSUED
t,a
5.15,'64 *160020
PERMIT NO. TOTAL