1984, 03-16 Permit: 84A-2312 Water Heater PLAN NUMBER APPL ICAT ION/PERM IT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY A ; zd
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. ? 00 -. f;K.01
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. Lehf1t' v'y Lco tic/4, 124, —i 8
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
r
North 1 South East I West
4. CONTRALTO LICENSE EXPIRES L .. I�� Size of Parcel Zone Classification Residential❑
LOLL 1 Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered sT
❑Yes 0 N ❑Req'd. J
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. :_ ,_ 1 ,
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck 1 Uncv.Deck Fin.Basement Unfin.Basement
6. (-
TYPE NEW ❑ ALT. No.Baths No.Floors No.Fin.Rooms No.Dwellings
❑ AD'N. ❑ RPL. ❑ MVE.
7. OF WORK ❑ BLD. 0 PLMB.,MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No
DESCRIBE WORK1� R,� Shorelines/Flood Hazard Plans Required❑
8. 0,) -deb` . , qL, 52 /� 'J' , Yes Not Applic.0 Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF
UTILITIES PUBLIC❑ SEPTIC❑
PRIVATE❑ SEWER❑ Public 0 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 Building
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction.SEE REVERS SIDE FO REQUIRED I E IONS J Plumbing
SIGNATURE OF APPLICATION �i// /13/ Z. PL
OWNER OR AGENT DATE / ! Mech.
SPECIAL APPROVALS r SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning Modular/
MFG.Home )-
Fire
Prevent. 0
O
Other(Specify) V
Engineer yl
J_
iz
Utilities 0/2
TOTAL $ ''
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BuildingT . , IN 180 DAYS ((�� Z.
DAT—S-0— 6 - 4 PERM112t .1 2'z * 2 O. 0 O t:liAL
b I