1979, 12-27 Permit: 79-9539 Hot Water TankPLAN 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 ADD
LOT
ESSed a* /� ,J ,91 //, kdL-
R
BLOCK —SUBDIVISION l /[r_Jj(//(r
LEGAL DESCRIPTION — SEE ATTACHED
3.
4.
eJ
ADDRESS' 74d,9-/-pas
CONTRA', OR
flrat 411P
AD iiv.-
/)0 d8 d7,' 7
DESIGNER
5' ADDRESS
ZIP
9.-/
PARCEL NUMBER /S
Required Set Backs in Feet
North
South (East
West
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
PLMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
VALUATION
9.
#1 t6),(--A} iff'itJ
Source GAS ELECTRIC
of
Utilities
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 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.
DATE
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D.
Env. Health
RECD.
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE/
OFFICIAL pal_
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
DATE
PERMIT NUMBER
16i — 31
03* *550
*550
*5.508
E
*000 8
95382.
12 -27 -79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS1BECOIXIE,,jS APE.RMIT. 0 5 3, 9 °z
*5.50 a I-
DATE REMARKS
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
d23S-1
e is' ;