1979, 12-13 Permit: 79-09040 Water 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
1.
2.
3.
JOB ADDRESS
.S': L'/ Z & %e' 4'1
Ler BLOCK
OWNERle 774).9/0/
ADDRESS
5. 3e'/2 Bu)'S 4)rS�,/'�.YNr
CONTRACTOR t� ,( ,/
4. DDRESS
nf lGcr�,a/iy !J.4,71,,—, ff/td,,
' /a 7/U 44-4, , R... K/ sic .4 2,e
SUBD VISI N
5.
DESIGNER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
PHONE
4•u
/rte
z:;70? ‘-
Required Set Backs In Feet
North 'South
East
'West
PHONE
ya S - 2- /00
Size of Parcel
Zone Classification
ZIP
IP
7%OZ/lv
Type Const.
Occupancy
Sprinklered
Lives ❑No ❑ Req'd.
PHONE
Valuation
Building Area In Sq. Ft.
ADDRESS
ZIP
DWL Area f Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
O NEW
O BLD.
O ALT.
O PLMB.
O AD'N.
❑ MECH:
O RPL.
O M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
UATI
8. V i
V TION
9.
?Ps r•'•- 7`- x45 s C./ r�//�'Ar /,''- Gi / /14'4,7
Source
of
Utilities
GAS
ELECTRIC
WATER
�v r
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 101 —- 77 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL,CONDITIONS:
Q
r'T ' �•%''t ' 7/'
DAT F(((`5/ ? OFFICIAL �C
` [ APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.yy/ ✓1.00
a,,,k74•1 /AV I✓.i G • GG-�
Plan Check
SEPA
Mobile Home -
Other (Specify)
TOTAL $ U O
PERMIT NUMBER
DATE
04*
E
9039-s
12-13-79
2 6479
*9.00
*9,00
*9.006
*0.00 0
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12"1.5.-79
9005
RECORD OF INSPECTIONS
Final Inspection
REMARKS INSPECTED BY
J5 -12-J6
603n
+,600R
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