1979, 09-25 Permit: G79-5088 Water TankPLAN 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
12.02-2.
LOT
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
OWNER
n -t-
PHONE
PARCEL NUMBER/S
ADDRESS
S tZ v
ZIP
Required Set Backs in Feet
North (South tEast (West
CONTRACTOR
5� h P19 0--,41-P1)
4. ADDRESS
CRI t3 C> X 2- 6,
DESIGNER
5.
PHONE
9a'l -O) )
Size of Parcel 1 Zone Classification
ZIP
9gii(z+
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW ❑ ALT. ❑ AD'N. RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
t AS
xX
1-1
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 2S 1� SIGNATURETD,,, I
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
cti fvsr %
DATE/0-/-76/OFFICIA
A nnnnl,rn rnn 100115 RInr
FEES COLLECTED
Single $
Building
Plumbing
Mech. .? e;‘)
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 9,"
DATE
PERMIT NUMBER
-7y-.54 F8
Os/7
04* *9.00
*9,00
*9.006
E *0.00
508.72
10-01-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10'-01-79
5'08.82 *9.0OR
INCDrrTrU