1979, 07-17 Permit: 79-541 Water TankPLAN NUMBER
1.
2.
3
JOB ADDRESS
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE. WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
LOT
BLOCK
7% • .26/
SUBDIVISION
LEGAL DES• CRIPTION - SEE ATTACHED
PERMIT NUMBER
79- SW
OWNEt�,... .n s
ADDRESS
‘17,714/3 -
CONTRAC OR
4.
O, )60--2am 3 7O1 7 Tf%
DESIGNER
PHONE
f 6-5790/
ZIP
PHONE -
9—//7D
PARCEL NUMBER/S
Required Set Backs In Feet
North South East West
Size of Parcel 1 Zone Classification
ADDR Eye
5.
ZIP
79;yo
PHONE
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
ADDRESS
ZI P
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE 0 NEW
7, OF
WORK 0 BLD.
DESCRIBE WORK
8.
TO
Split Entry
Split Level
Rancher
❑ ALT. 0 AD N. 0 RPL. 0 MVE.
PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
/ 7 /A2 v iv i lc�
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
I hereby certify that I have read and examined this applica ion 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
Fore Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE 7-17-37 0F FI CIA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
5—s-0
*550
*550 t
*5506
8 *000
54.02
07-17=79
8 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07'17=79
5412
*5,50ap'
CC
0
U
w
0-
V) rn