1983, 06-21 Permit App 83A-5631 Water HeaterPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1' S. 4101 Conifer Court PARCEL NO.
Lor BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
3 Jirr Ash
MAILING ADDRESS
4.
DESIGNER
5
Mechanical
Ave
PHSENE.. 8600 PHONE
}}GG ��55 ZIP
ane, Wa 992
to:
aoum East West
PHONE I� Size of Parcel Zone Classification
4147 Rwitlential ❑
Commercial ❑
219202 Type Const. Occupancy Sprinklered
7 ❑Yes El No ❑Req'd.
PHONE New Caul Valuation Remodeled Valuation Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
17. CHANGE OF USE FROM
TO
Corer Dock
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ❑ NEW ❑ ALT. ❑ AD' N. kIRPL. ❑ MVE. No. Baths No. Fleors No. Fin. Rooms No. Dwellings
7•
OF 12.BLD. ❑ PLMB. O MECH. ❑ M.H. ❑ POOL 0 OTHER
WORK Certifi. of Exempt. Required
yes❑
orvariance
No[] Number
Received
DESCRIBE WORK
Yea El No -
B
ke lace Gas 3:ater Heater Shorelines/ Hazard
Pans Required
yeso Nott
Ves❑ Not PPlic.❑
Received ❑
VALUATION I SOOUFCE GAS ELECTRIC WATER SEWAGE gteeyhip
9'
IC El
UTILITIES PRIVATE ❑ SEWER ElPublic 1-1Private ❑
FEES COLLECTED
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 to give au-
Building
thority 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
SIGNATURE OF /�� APPLICATION
Z- 6 83
OWNER OR AGENT -fdau. !/ DATE 21
Mach.
SPECIAL APPROVALS I SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health
Planning
Plane PERMIT IS NONTRANSFERABLE
E+am.
Building
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech, IN 180 DAYS
Plan Check
SEPA
Nodular/
MFG.Home
Other (Specify)
L
TOTAL $/�
PERMIT NUMBER
13(03
WHEN MACHINE VALIDATED IN THIS SPACI
THIS BECOMES APERMIT.
DATE ISSUED 21- 8 j PERMIT AGlLL 3.1 7
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