1979, 08-15 Permit: 79-2275 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
JOB ADDRESS
1.
LOT
2.
C. 7904/ J3 o -o -
BLOCK �SUBDIVISIO
LEGAL DESCRIPTION - SEE ATTACHED
3
OWNER
PHONE
Rat- ieS7/
PARCEL NUMBER/S
ADDRESS
cuo
ZIP
Required Set Backs in Feet
North 'South [East 'West
GONTRACTO /
4. "l9'iG0 Y -1'
ADDRESS
DESIGNER
5' ADDRESS
E'50s/ %/
CHANGE OF USE FROM
6.
TO
PHONE
535- 1177K -
ZIP
PHONE
ZIP
Size of Parcel
Type Const.
Zone Classification
Occupancy
Valuation
DWL Area I Basement Area
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
Garage Area
Split Entry
Split Level
Storage
Rancher
TYPE
7. OF
WORK
❑ NEW
0 BLD.
❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
O PLMB.ECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Q .D.„
ELECTRIC
Source
of
Utilities
GAS
WATER
X
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
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
6.1.0. 1,31000
OFFIC
APPRO FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. 4
Plan Check
SEPA
Mobile Home
Othe(Specify) 3. Dv
TOTAL $ / �O
PERMIT NUMBER
�Z7
DATE
04*
A
227.48
08-15-79
g 6479.
*9.00
*9.00 U)
*9.006
*0.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THISRCOITIE5S A RE 'MIT.
227,52 *9,00-°-F-2
I—
U
w
0_
V)
DATE
r
RECORD OF INSPECTIONS
Final Inspection
REMARKS INSPECTED BY
o8 -12-.1a
55.1V%
V *-0-6 2
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