1980, 04-22 Permit: 80-3781 Water HeaterPLAN NUMBER
Y
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
O�-;��� LEGAL DESCRIPTION —SEE ATTACHED
LOT I BLOCK 15UBDIV15ION PARCEL NUMBER/S
�PHO
OWNER �.+��i✓i K'�[�_ "' V� ��� �` l� ^ N E
3. V
ADDRESS ZIP Actual Set Backs in Feet
C e tZA�! North South East West
CONT CTOR PHONE Size of Parcel Zone Classification
// L Type Const. Occupancy Sprinklered
4. ADD PE55 i` P
! 2 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP Main Floor I Upper Floors Garage Ar;T Storage
CHANGE OF USE FROM fTo
Area of Decks Finished Basement Unfin. Basement
s.
No. Baths No. Stories I No. Rooms No. of Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
D�IBEWORK �V`® Enum. Dist. Location (Area) FEES COLLECTED
8. (�(,�• t✓I, (,�j
VALUATION1615URCE GAS ELECTRIC WATER V SEWER Ownership rUSE CODE
9. UTI�" Public ❑ Private
Single $
1 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 Building
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 INSPECTIONS Plumbing
DATE OF APPLICATION �J SIGNATURE OF APPLICANT 4 dta Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
FOR GAS APPLIANCES
PIPE SIZES y(,�,.(�-,4
PIPE LENGTHS
BTUS
ng.kVician PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT.. NUMBER Q
— -sV
04* *9.00
*9,00
*9.006
E *0.00
37a0;?
04-22-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.O(i47 2 Z'- g° G 7
DATE ISSUED PERMIT NO.
TOTAL