1983, 05-02 Permit: 83A-3527 Pool HeaterPLAN NUMBER APPL IOAT ION /PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY YA ''_�?--7
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
2 j/
LOT
BLOCK
LEGAL DESCRIPTION:
2. I
FSUBDIVISION
OWNER
PHONE
PHONE
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
5 ' �JC`Js L.. IV 10 t✓ rLS T -f
North South East West
CONTRACTOR
LICENSE EXPIRES
HONE
Size of Parcel
Zone Classification
Residential
4. S S r.2_a �L� C� .
q-.� �
Commercial ❑
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
14-C-4- 5 • 4!�' Lr_ "-&j
C't-2 - 0(,1,
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unf in. Basement
6.
TYPE
No. Baths No. Floors
No. Fin. Rooms
No. Dwellings
O NEW 11 ALT. D'N. El RPL. ❑ MVE.
7. OF ❑OTHER
Yeso No❑
Number
WORK ElBLD. ❑ PLMB. MECH. ElM.H. ❑ POOL
Certifi.ofExempt. Required
or variance Received
Yes❑ No❑
8 DESCRIBE WORK t
Shorelines/ Flood Hazard
Plans Required ❑
COL e: PC ris'Z_ $T ti cwt l
Yes❑ Not Applic. ❑
Received ❑
VALUATION
9•
SOOURCE
GAS ELECTRIC
PUBLIC ❑
SEPT CWATER G❑
1
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 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. SEER E SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF- APPLICATION �- a
OWNER OR AGEN -'j DATE >- f� _
Mach.
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM.
FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
Fire
MFG. Home
>
Prevent.
a
C
Engineer
Other (Specify)
C.
U
Utilities
u
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN
THIS SPACE,
Plans
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech
IN 180 DAYS
f` {{ QQ
6s%&O 2 - u 3
�} 5 2. 7 z * 19. i'o-j
_
DATEPERMA
.