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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,