1981, 02-19 Permit: 81A-1641 Water HeaterA
PLAN NUMBER
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
1.
-9 leo7 rh s1cr
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
ADD
OWNE
a i20/13(nfii P b
5.
. 9 '7Lv /97 S /
CONT CTOR
4.
AD
DESIGNER
PHONE
Cly 2/ 7
PHONE
6
Actual Set Backs in Feet
North 'South LEast (West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
Oyes ❑No 0 Req'd._ _
Valuation 1 Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE -OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin- Basement
TYPE NEW
7. OF
WORK ! 0 BLD.
❑ ALT. 0 AD N.
L/MB. 0 MECH.
❑ RPL.
❑ M.H.
8.
9.
DESCRIBE WORK
C #.,:vc)C3 E rJ f-tr
VALUATION
SOURCE•
OF
UTILITIES
GAS
•0 MVE.
0 POOL
cePediL i b
ERIC
WATER
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
• of EXEMPTION
Req'd.
Recd.
Not Req'd.
SEWER
Enum. Dist. I Location (Area)
Ownership
Public 0 Private 0
USE CODE
I hereby certify that 1 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 INSPECT' IS
DATE OF APPLICATION _ SIGNATURE OF APPLIC
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
UtIIItIe
Plans Examine
SEPA Checkll
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
•
Single $
Building
00-
Plumbing
Mech.
Plan Check
SEPA.
Mobile Home
Other (Specify)
TOTAL
0
PERMIT NUMBER
b { Al -
03 ,'ac9c9
9-00 St ,
A tcoto
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
1"641_
PERMIT NO.
*19. 0 0 °a it! —
TOTAL