1979, 12-11 Permit: 79-8929 Water Heater PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE `,/ 2 r
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES p 3 * * 5. 5 a
JOB ADDRESS
1. f ,,4 __ 7 z-f LEGAL DESCIRIPTION — SEE ATTACHED * 5 % C
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 5 5 0 x
2 OW ER�� PHO�N�jE p E k Q. 0 n'
ADORES �"7 &. Zlp Required Set Backs in Feet v y `ten"
a. / ` / ���� North (south East (west 1 2— 1 1 —7 9
CON-FY/ACTOR A)—(9--2(
PH E Size of Parcel Zone Classification4. _ <� �f//%T -2 6479.
AdDRE:s /,1 �,(/�q ) ZIP Type Const. Occupancy Sprinklered
Lfr ,t./ /e) 7 i� -C) EYes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER -
WORK ❑ BLD. .PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK ,¢- ,,.-
8. �7G'�1 d-e/ 7e),te-f ar__C{f, _ 4.4‘../ FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities Single $
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 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 theme
performance of construction. Plumbing `-
DATE SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
cc
SEPA Q
•Planning — U
w
2
Fire Marshall Mobile Home T
Co. Engineer Other (Specify)
Utilities .j( >
TOTAL $ !J -�_
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BLCOMES A 1PERMIT.
DATE/100g OFFICIAL �I4t Yom✓ L '_' 1' 1'- ! 11 'i *, C /, ��
APPROVED FOR ISSUANCE —