1983, 05-06 Permit: 83A-3731 Pool HeaterPLAN 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
STR�ADDRESS �t PARCEL NO.
LOT LOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWt�IE�i,' S PHONE P�NE_ �.
3.
MAIL? ADDRESS i
ZIP
Actuai Set Backs in Feet io:
U T
No. Dwellings
North South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential❑
Certifi. of Exempt.
Required Yes❑ No❑
Commercial El4.
WORK El BLD. ❑ PLMB. ElMECH. ElM.H. El POOL
or Variance
Received Yes❑ NoF1
DESC IBE WORK )
8• M gl-r 'Z ii
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
VALUATION
SOOUFCE
GAS ELECTRIC
PUBLIC E]SEPT
❑Yes 171 No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
PRIVATE ❑
SEWER ❑
Public ❑ Private.Q
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
SPECIAL APPROVALS
I SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Prevent.
Engineer
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
T �. IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
PERMIT NUMBER I
-.3-731
TOTAL $�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
OS` -06-83 3%3,1z
DATE ISSUED PERMIT NO.
*19,00°
TOTAL
Y
CL
O
V
W
J_
U.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE ❑ NEW El ALT. ❑ AD'N. 1:1 RPL. ❑ MVE.
El OTHER
Certifi. of Exempt.
Required Yes❑ No❑
Number
WORK El BLD. ❑ PLMB. ElMECH. ElM.H. El POOL
or Variance
Received Yes❑ NoF1
DESC IBE WORK )
8• M gl-r 'Z ii
Shorelines/ Flood Hazard
Plans Required ❑
cl::a' -
Yes Not Applic. ❑
Received ❑
VALUATION
SOOUFCE
GAS ELECTRIC
PUBLIC E]SEPT
CSEWAGS
Ownership
FEES COLLECTED
9•
I UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private.Q
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 REVERSEZfDEFOAj!g9LIIR15D Ib19PECTIONS
Plumbing
SIGNATURE OF APPLICATION
/, � DATE s S
j
j
Mech.
OWNER OR AGENT _.
SPECIAL APPROVALS
I SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Prevent.
Engineer
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
T �. IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
PERMIT NUMBER I
-.3-731
TOTAL $�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
OS` -06-83 3%3,1z
DATE ISSUED PERMIT NO.
*19,00°
TOTAL
Y
CL
O
V
W
J_
U.