1979, 07-26 Permit: 79-1075 Pool 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.
LOT
2. /
JOB ADDRESS L !1
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
2
SUBDIVISION
/L1nCesS -S11/
/151 /-17 S
OWNER , / %��
3.ADDRESS /
CONJI3ACTOR
Ke rt,oZ
4. ADDRESS ry 4:"?.j
PHONE, 3 /
y. .,
PARCEL NUMBER/S
Required Set Backs in Feet
North (South East
PHONE
(West
Size of Parcel I Zone Classification
ZIP /
7? -2 r
DESI.CyNER ,L
nf�6t
5.
ADDRESS
LC/ f c' Ai;
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes DNo ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area l Basement Area
Garage Area Storage
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
O ALT.
O PLMB.
0 AD'N.
0 RPL.
ECH: ❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. .S[(/, #r7
VALUATION
9.
Source
of
Utilities
GAS
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 Jaw regulatin onstr uction or the
performance o constr ction.y
DATE
G 7SIGNATOR
'/ //
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
i
DATE 7 2-5 • OFFICI
APPROEVFOR ISSUANCE —
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
PERMIT NUMBER
)O1
04*
04* *1600
* 1600 t5
* 1600'6
A *0.00 0
107.4
07-26-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOME APE MIT.JO
07-26-79 107.55 *16.0,0a