1979, 10-11 Permit: 79-5807 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.
JOB ADDRESS
/. - /peva. ?j 7 o,
LOT BLOCK ISUBDIV SION
LEGAL DESCRIPTION - SEE ATTACHED
OWN
E
r,0.da) &24 --,CJ
ADORESS
/8003 . -di
CONTR TOR /[A/_
4.
' �t-�
5.
DESIGNER
PHONE
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
Size of Parcel
East
'West
Zone Classification
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
DYes ONo D Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE D NEW
7. OF
WORK D BLD.
DESCRIBE WORK
8.
VALUATION
9.
D ALT.
❑ PLMB.
�D/AD N.
�LMEC H:
O RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
Srce
of
Utilities
ELECTRIC
WATER
SEWER
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 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
OFF
APP'' 1 FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
9 0j
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PERMIT NUMBER
79-5P
DATE
04*
E
58Q62
0-11
6479.
*9.00
*9.00
*9.008
*Q-00 8
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COM SIA PERMIT.
U17:11 aH7151'
5+80.7= *9.0,0 2.171