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1979, 07-06 Permit: 79-179 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 JOB ADDRESS PARK ROAD, N. 2801 LEGAL DESCRIPTION — SEE ATTACHED LOT BLOCK SUBDIVISION PARCEL NUMBER/S 2. OWNER RON ERBEZNIK ADDRESS N. 2801 Park Road CONTRACTOR 4 ADDRESS 5EARS-0WENS P.O.BOX 3707 TA DESIGNER 5. ADDRESS CHANGE OF USE FROM TO 6. PHONE 926-8691. ZIP PHONE 489-1170 ZIP 99220 PHONE ZIP I YPL ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7 OF ❑OTHER WORK ❑ BLD. RI PLMB. ElMECH: ElM.H. ElPOOL equired Set Backs in Feet orth South East ize of Parcel Zone Cla Type Const. Occupancy Sprinklered Source I ❑Yes ❑No ❑ Req'd. aivation Building Area in Sq. Ft. 9. DWL Area Basement Area Garage Area Storage Single $ Split Entry Split Level Rancher 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 No. Baths No. Floors No. Rooms Rec. Room DATE SIGNATURE _ Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: CERTIFICATE Req'd. I Recd. Not Req of EXEMPTION SEPA Planning DESCRIBE WORK g Re lacement of p H t W t T k FEES COLLECTED o a er an VALUATION Source GAS ELECTRIC WATER SEWER 9. of utilities XXXX 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 _5.50 DATE SIGNATURE _ Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. Plan Check Env. Health SEPA Planning Mobile Home Other (Specify) Fire Marshall Co. Engineer PERMIT NUMBER -27-171 DATE July 6, 1979 03* *5,50 *5.50 B *0.00 07-06-79 ;F 6479. Utilities 5.50 TOTAL $ Zone Clearance WHEN MACHINE VALIDATED IN SEPA Checklist THIS BECOMES 6-7 A PERMIT. 7 DATE OFFICIAL _ O r — 0 6 — /7 7 1 7Qc5 .Srn©-1.