1982, 04-19 Permit App: 82A-2918 Piping & Water HeaterSPOKANE 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
1. E- ► LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
2.
P 1 A - -2!-'A \g3
OWNER
PHONE
3.
ADDRESS
ZIP
Actual Set Backs in Feet
-t-4
E- i\
- \0
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZIP
Type CoWsq
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
TYPE ,��,�/
❑ NEW ❑ ALT. 2SAD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7. OFElOTHER
ElBLD. 1-1PLMB. MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
'Pk
Enum. Dist. Location (Area)
FEES COLLECTED
8.6A =v ��411
1 E. o
VALUATION SOURCEGAS
ELECTRIC
ATE
SEWER
Ownership
USE CODE
OF
9. UTILITIES
Public El 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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
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
A��Mech.
DATE OF APPLICATION SIGNATURE OF APPLICAN
SPECIAL APPROVALS
SPECIAL CONDITIONS: 1 r
NAME DATE
-4'
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS
SEPA Checklist
THIS BECOMES A PERMIT.
3
04* *1&00
* 1 8,00
*18006
A *000
291.72
04-19-82
9- 6479,
ing Technician PERMIT IS NONTRANSFERABLE 0'4 -19" 8' 2 2 9 L 8 z * 1 8. 0 0 a H
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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