1980, 03-04 Permit: 80-1753 Pool HeaterPLA" NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS e
re 71Y -Sty,`
LEGAL DESCRIPTION -SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/5
2.
I
i
OWNER
PHON
3 ?fid
3.
�L�C .Si.j:ti�ry�ic s� a%r
105'g—
ADDRESS
ZIP
Required Set Backs in Feet
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
ly? , r't z [ir�.S .s ���.-
vo -.7.6.6 5
4.
ADDRES
ZIP
Type Const.
Occupancy
Sprinklered
/ L
�j"'
3 / r d e c -j o !//
vT
�.y�' /
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE E] NEW El ALT. 1:1AD'N.
❑ RPL. ElMVE.
7,
OF
❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
❑ BLD. ElPLMB. ❑ MECH:
ElM.H. El POOL
WORK
of EXEMPTION
DESCRIBE WORK
8.wigti77r •s % i /•r �� 6Ci" lJ�� t�����r l/
VALUATION Source GAS ELECTRIC WATER SEWER
of
9, Utilities
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 authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
•� — Y .��� s.tAC�'� .
DATE SIGNATURE
SPECIAL APPROVALS SP AL CONDITIONS:
DEPT. REQ -D. RECD.
Env. Health � 0�� J
000
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DAT LVED
A `
FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
/aLMech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
c /753
04* *1&00
*1x00 N
*1a0061
E *0.00 00
17522
03-04-80
2 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS DEQ U $i A PEf�MIT.
i. ` q,i (I '. l '�
*18.00o�-,
CC
0
U-1
2
z