1981, 04-01 Permit: 81A-2974 Pool HeaterPLAN NUMBER
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
1.
2.
3.
JOB/ADDRESS
LOT/ �BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNE
/ILL -K _
A▪ DDRESS
PHONE
912 /Pi
ZIP
CONTRACTOR
4. ..� `1 / ,
ADDRESS
/v ((l
PHONE
/9 07A'
Actual Set Backs in Feet
North !South LEast 'West
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL. ❑ MVE.
❑ M.H. (FOOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. ,t; ONE,
VALU TI S URGE GAS ELEC RIC
OF
9. UTILITIES
Enum. Dist.
o'ZNo) 0 -c -c: B T'4.
ILocation (Area)
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 44-/ — y
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
1
P--* - / " /a'
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech. / f
Plan Check
SEPA
Mobile Home
Other (Specify)
$
TOTAL
PERMIT NUMBER
S"/.4 -
04* * 1 9.00
* 1 9.00
* 19.006
A *0.00 0
297. 3.2
04.-01-81
1 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
c 1•
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DAT 145tJOD1 -'8.1
PERMIT 2.4 7, 4 Z
V t
* 19.11:14-�