1981, 06-04 Pemrit: 81A-5520 Pool HeaterPLAN NuMgER
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
rfAe'AAy
LOT
BLOCK
SUBDIVISION
OWNER /
3 // -6 //-6i .l /7- 0r �d
4.
ADDRESS G
CONTRACTOR
Y,7'P r ( tr./ e% 5 �d C -
ADDRE S
x 37/8 '' —
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
TO
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S 6-4/.7/ - 5;7O3 -5
Actual Set Backs in Feet
North 'South
Size of Parcel
Type Const.
Occupancy
Main Floor
No. Baths
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
070
WATER
East
Wes
Zone Classification
Sprinklered
Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
No. Stories
Storage
Unfin. Basement
No. Rooms
CERTIFICATE
of EXEMPTION
Enum. Dist. `Location (Area)
Req'd.
No. of Dwellings
Rec'd.
Not Req'd.
SEWER Ownership
Public ❑ Private ❑
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 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
,ss�IgNc /C'
Other (Specify)
LC'
De
TOTAL $ I7 XX
PERMIT NUMBER
8/A- 552 o
04* *17.00
* 1700 rri
* 17.006
A *0.00 8
551.82
06-04-81
6.479.
b
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06-44.-.81
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
55202 *17.00+