1980, 08-20 Permit: 80-8870 Pool HeaterUMBER APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
/ NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
No. Baths No. Floors No. Rooms Rec. Room
TYPE 13 NEW ❑ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK El BLD. ElPLMB. ❑ MECH: ElM.H. El POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK , /
8. , rr, .z, . •, :yd MC 47 Ze r - ,,7 L �'G;L R� f
--F
VALUATION j Source GAS ELECTRIC WATER SEWER
of y/-
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.
DATE ci4' „7C;. /4�k'C, SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
AL CONDITIONS:
SEPA Checklist JCS �LOI
DATE" OFF ICIAL�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
PERMIT NUMBER
DATE
i 600
* 1 6.00
0 -20-80
6, 4 7
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
SEPA
JOB ADDRESS _ L h
LEGAL DESCRIPTION — SEE ATTACHED
1.
// lit) 3
�>
V)
z
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2
Y'.s1Gl
190b
I
LL
jfc (jo'r7 /77 G / 't' c c. s y i ` C
-2 0- 4- _ C, G/
Yn
PHONE
s.
OWNER
cn'7,s
A tic
yPjl%-Olt,
ADDRESS
ZIP
Required Set Backs in Feet
//,00-3
46
North South East West
CONTRACTOR
`�h
PHONEv
�fx'�' 76 5
Size of Parcel
Zone Classification
1� ►'C
4 G
4.
Type Constccupancy
O
Sprinklered
ADDRESS y
ZIP
--Z .i
.
❑Yes ❑No [IReq'd.
25- 3 -1 / S
PC 0 �� Cv �' �
ZC
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 13 NEW ❑ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK El BLD. ElPLMB. ❑ MECH: ElM.H. El POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK , /
8. , rr, .z, . •, :yd MC 47 Ze r - ,,7 L �'G;L R� f
--F
VALUATION j Source GAS ELECTRIC WATER SEWER
of y/-
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.
DATE ci4' „7C;. /4�k'C, SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
AL CONDITIONS:
SEPA Checklist JCS �LOI
DATE" OFF ICIAL�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
PERMIT NUMBER
DATE
i 600
* 1 6.00
0 -20-80
6, 4 7
SEPA
o
U
w
d
Mobile Home
V)
z
Other (Specify)
TOTA L $ + `v
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i
U...20•g,�, x'7.02 *16.00u