1979, 09-04 Permit: 79-3379 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 4 COPIES
JOB ADDRESS
3.
LOT
I aVqd
BLOCK SUBDIVISION
CONTRACTOR
4' ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
7,,?6- Y333
ZI P
11�d37
PARCEL NUMBER /S
Required Set Backs in Feet
North 1South (East
West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ RPL.
CH: ❑ M.H.
❑ MVE,
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Storage
Rancher
Rec. Room
Not Req'd.
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
DESCRIBE WORK
VALUATION
9.
Source
of
Utilities
GAS
Xxxx
ELECTRIC
WATER
SEWER
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 ordir. .a erning this
type of work will be complied with whether specified herein or not. T anting of a per it does no presume
to give authority to violate or cancel the provisions of any other state r to al law regul. - , cons ctipn or the
performance of construction.
DATE
DEPT.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
SIGNAT RE
SPECIAL APPROVALS
REQ'D. REC'D.
Zone Clearance
SEPA Checklist
SPECIAL ° ONDITIONS:
/6,9 /
DATE% - 7gOFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech
Plan Check
SEPA
Mobile Home
Other (Specify)
/(D
TOTAL $ / c,
PERMIT NUMBER
- 337
/ 71
[) *1600
*1600
*16006
E *000
337,8
09 -04 -79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COM APE MIT.
0�9 -0 E -'7� 33Z9( *16.00°1, 1
RECORD OF INSPECTIONS
REMARKS
Final Inspection
INSPECTED BY
VttAd
Ca— Ott—ao
*GOC 2
+�J900