1979, 12-14 Permit: 79-9078 Water HeaterPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
P d1,00
DATE za // - —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
No. Baths No. Floors
JOB ADDRESS
TYPE El NEW El ALT. 11AD'N. El RPL. 1-1MVE.
LEGAL DESCRIPTION — SEE ATTACHED
❑ BLD. LMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE
Req'd. Recd. Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK /
LOT
BLOCK
SUBDIVISION
VALUATION Sourc,6 GAS ELECTRIC WATER SEWER
PARCEL NUMBER/S
2.
9, Utilities
Single $
1 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
OWNE
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
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to give authority to violate or cancel_ the provisions of any other state or local law regulating construction or the
3.
performance of construction.
Plumbing
DATE SIGNATURE—
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
ADORES
DEPT. REQ'D. RECD.
ZI
Required Set Backs in Feet
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?
North South
East West
Mobile Home
CONTR C R
PH E
Size of Parcel
Zone Classification
Z�
Utilities
S
TOTAL $
Zone Clearance
4'
ADDRESS
THIS BECOMES A PERMIT.
y 1 ; 7�
ZIP
Type Const. I
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
I Storage
PERMIT NUMBER
P d1,00
DATE za // - —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors
No. Rooms I Room
TYPE El NEW El ALT. 11AD'N. El RPL. 1-1MVE.
], OF El OTHER
❑ BLD. LMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE
Req'd. Recd. Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK /
FEES COLLECTED
8
VALUATION Sourc,6 GAS ELECTRIC WATER SEWER
of
9, Utilities
Single $
1 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
Building
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.
Plumbing
DATE SIGNATURE—
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Z�
Utilities
S
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
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THIS BECOMES A PERMIT.
y 1 ; 7�
DATIc OFFICIAL