1979, 10-15 Permit: 79-6032 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.
4.
JOB ADDRESS n /OcQO a.
•
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
ADDRESS
/nD."c:,p�,
C-O-NTT.R ACTOR-.
/9)/0e-co
/�/1 �
c2C ' ( / /c/ e c o
PHONE
PHONE
7()
PARCEL NUMBER/5
Required Set Backs in Feet
North 'South [East 'West
Size of Parcel
Zone Classification
DR 0 S
ZI 7Q
Type Const.
Occupancy
•
Spr Inklered
Oyes ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
OF
WORK
O NEW
❑ BLD.
0 ALT. 0 AD N.
LMB. 0 MECH
O RPL.
O M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
- CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
54- rce GAS
of
Utilities
ELECTRIC
x
WATER
SEWER
1 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 correc . 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 J
O F.F �ta�
AP' e. r FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
P
PERMIT NUMBER
79—(069, 9 --
DATE
,03*
*550
*.550 1
*5506
E *Q00 8
,6031R
10-15.79
a 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
TH IS$ECOMEIS A puM 1T. 6 0'3, 2
'*5.5)00.1,