1979, 11-05 Permit: G79-7263 Water HeaterIIIPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
3
5.
6.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS //6
-0'72./
LOT BLOCCKJXISUBbIVIS�ON
n
OWNER
ADDR
CONT CTOR
rU
767
DESIGNER
ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
CHANGE OF USE FROM
TYPE
7. OF
WORK
9.
❑ NEW
❑ BLD.
DESCRIBE WORK
VALUATION
P1HONE //
-Zr'i' // 76/
•
PHONE
ZIP
TO
PARCEL NUMBER/S
Required Set Backs in Feet
North !South East West
Size of Parcel Zone Classification
Type Const.
Occupancy
Valuation
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
DWL Area Basement Area Garage Area
Split Entry
Split Level
Storage
Rancher
❑ ALT. 0 AD N.
PLMB. 0 MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
//d //G 7--
Not Req'd.
ource
of
Utilities
GAS
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 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 OFFICIA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
79--72
DATE %D
04* *9,00
*900
*9.006
E ` *000
726,2
11-053-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'105'-79 72'6.`35 ,*9,00 0J