1979, 08-01 Permit: 791436 Gas 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 ESS
I 7 I j A -
OT BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
OWN R
3.
AD R -I? A W i
C TR T R 03141 ---141-NiftA ADDRESS
PHONE
ZI P
Required Set Backs in Feet
North (South East
Wes
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
ADDRESS
ZIP
CHANGE OF USE FROM
6.
TO
Valuation Building Area in Sq.
DWL Area I Basement Area Garage Area
Split Entry Split Level
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT. ,. ❑A9'N. ❑ RPL. ❑ MVE.
,/
❑ PLMB. tjd MECH: ❑ M.H. ❑ POOL
9.
DESCRIBE ORK /
VALUATION (/\ So, ce GAS
of
Utilities
❑ OTHER
r
Pie �
ELEC RIC 1'')
/
No. Baths
No. Floors
No. Rooms
Ft.
Storage
Rancher
Rec. Room
Not Req'd.
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
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 constr ction or the
performance of, construction.
DATE
SIGNATURE
SPECIAL APPROVALS
DEPT. RECD. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
Io t- =1�
DATE
7/1
l / -7q OFFICIAL W
APP'. 0R ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. '
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
PERMIT NUMBER
04* *1600
* 1600
* 16006
E *000
141.22
08 -01 -79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08 -01 -79
143.62 *16.00a-J
RECORD OF INSPECTIONS
DATE REMARKS
, • c
Final Inspection
INSPECTED BY
qttAd
09-01
J /SS
E .000 2
.1 POOR
•1900
OV4, 41 9'00