1983, 07-07 Permit: 83A-6266 Pool Heater, PipingPLAN NUMBER
APPLICATION/PERMIT
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
STREETADDRESS PARCEL NO.
1. h ADAM
2. LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OW ERPHONE PHONE
3. y -A Sin C� 1 0( '2_Z -
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
A
5 A
2-C Cc
North South East
West
CONTRACTOR {{
LICENSE EXPIRES
PHONE_ _
3 `J
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
a1T�
4.
J+�
ADDRESS
ZIP
Type Const.
Occupancy
Spr❑Norte
r�1��-
ti7�� Rte'
❑Yes ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
TUncv.per
Deck_--'
Fin. Basement
Unfin. Basement
s.
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
.NEW ❑ALT. El AD' N. El RPL. El MVE.
7 OF 11 OTHER
WORK E3 BLD. ElPLMB. (MECH. 1:1M.H. 11 POOL
�ifi.ofExempt.
Required
YesNo❑
❑
Number
/
or Variance
Received
Yes ❑ No❑
DESCRIBE WORK� � i �)
Shorelines/Flood Hazard
Plans Required Ell
j V
Yes Not Applic. ❑
Received ❑
VALUATION
9•
I SOURCE
GAS
ELECTRIC
WATER PUBLIC 1-1SEPT
ICSEWAGE
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
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
p p g g p
does not resume to
p give au-
Building
thority to violate or cancel the provisions of an other state or local law regulating construction or the performance
of construction. SEE REVERSE $IQE R AtO RED INSPECTIONS
Plumbing
SIGNATURE OF —_�//" %� C� APPLICATION �Z 9
OWNER OR AGENT `�/ �_ DATE
Mach.
SPECIAL APPROVALS
PRELIM. FINAL D.
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
(SEE
E SIDE FOR NOTICE)
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building I�
Tech. IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
&k
PERMIT NUMBER
DATEQSSUEW 3 PERMA2. u. 6 z * 18. 0 0 ¢&AL
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