1983, 09-19 Permit: 83A-9199 Hot Water Tank PLAN NUMBER APPLICATION/PERMIT PERMNUMBE y
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY ��}}-\\
et) NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/ (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREETApDRESS PARCEL NO.
1.
/(00 / �. 1 „ ,cit)
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER/ ��z �o431 PHONE
3. C C 'ti°rC of V
MAILING 9 E S -...1.6 ZIP Actual Set Backs in Feet to:
//t C q C-�. el/ 9� North 'South East I West
CONT CTOR LICENSEE I O S o27� Size of Parcel Zone Classification Residential
4 lC [_.0 (1� L-L d �7L�_ Commercial CI
•
ADDRE ZIPS Type Const. Occupancy ❑Yes Spr❑Norte ❑Req'd.
7
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 L * * I U
TYPE CI NEW ❑ ALT. ID AD'N. , RPL. CI MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
r n c,
7. OF ❑ OTHER
WORK CIBLD. ❑ PLMB.iileMECH. ❑ M.H. CIPOOL Certifi.of Exempt. Required Yes No❑ Number ` `_
or Variance Received Yes El No❑
r
DESCRIBE WORK , L Shorelines/Flood Hazard Plans Required❑ O— i _
8. &�t�i'-(:_, i ,� �1 Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership / / 7i.'
9 OF PUBLIC❑ SEPTIC❑ 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 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 REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF ., APPLICATION /%_ t�
OWNER OR AGENT DATE Mech. (!i'
SPECIAL APPROVALS SPECIAL CONDI IONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE7�_
Env.Health �— -g--0C.-/----1 Iii /
Z,e.�� SEPA
Planning
FirJ /' ,3 1 �� /� Modular/
MFG.Home
me devent.
O
C.
Engineer Other(Specify) LV
9 _ J
Utilities /& 2"--.!...........--)
� �'
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 IN 180 DAYS 0 9 - 1 9 - 8 • �' 19.9 * 16. °
IN DATE ISSUED PERMIT NO. TOTAL