1979, 12-11 Permit: 79-8935 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 ADDRESS'
1. /6604 e
2.
3.
SUBDIVISION
dA„
4 n j
/S
CONTRAC R
4' ADDRESS ! tY B
ZI P
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
East
West
PHONE
� 9//7d
Size of Parcel
Zone Classification
370 7
zlP
Type Const.
Occupancy
Sprinklered
Yes ['No 0 Req'd.
DESIGNER
6' ADDRESS
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 0 ALT. 0 AD N. 0 RPL. 0 MVE.
yyyyyy
1:1 OTHER
��������_��_
❑ BLD. LMB. 0 MECH: 0 0 POOL
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
DESCRIBE WORK 1
tiS
VALUATION Source GAS ELECTRIC WATER I SEWER
• of
9. Utilities
Req'd.
Rec'd.
Not Req'd.
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 author:1[y 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 ti09 OFFICIAL
a�ac.Lc.ayt�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. -
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
PERMITNUMBER
-cm- 135
04* *9.00
*9.00 N
*9.006
E *000 8
89342
12-1U-79
2 6479.
,WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12 1 Il l; .171
91
893,5= ;49,00 RR'
CC
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