1979, 08-23 Permit: 79-2687 Hot Water Tank !PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 79�// �_
7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 1-/k' ` 7
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
............p 'r , 04* * 9,00
JOB ADDR S ei LEGAL DESCRIPTION — SEE ATTACHED
,. c7 —/,� * 9.00 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 9,O O U
2. 7
OW N E PHONE
E 0,0 0 c
3. %yte/ 47-00-961--,:-e'
-f�`/ � !/ /7(r
ADDRES ZIP Required Set Backs in Feet 2 6 8 6
41.--,---)-2-€_, North (South East (West 0 8-2 3-7 9
CON RACTOR J PH E Size of Parcel Zone Classification
4. Q i y 5/-//7t) 6479,
ADD .' S�, �. / ZIE, Type Const. Occupancy Sprinklered
[,//%j .-1 7o 71;,1-,VCI Yes CI No ❑ Req'd.
DESIGNER cJ PHONE Valuation 1Building 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. El AD'N. ❑ RPL. ❑ MVE.
7, OFClOTHER Req'd. Recd. Not Req'd.
WORK CI BLD.BLD. Y" PLMB. CI MECH: ❑ M.H. CI POOL CERTIFICATE
/q of EXEMPTION
DESCRIBE WORK ��7 .7L 7:6)ez- /
8. / uta i/«� FEES COLLECTED
VALUATION 96urce GAS ELECTRIC WATER SEWER
of
9. Utilities !X` K
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 the
Plumbing
performance of construction.
DATE SIGNATURE_ Mech eA
SPECIAL APPROVALS SPECIAL CONDITIONS: �'`�
DEPT. REQ'D. REC'D. Plan Check
Env.Health cc
SEPA o
F-
U
Planning - w
3-
Mobile Home
Fire Marshall
-
Co. Engineer Other (Specify)
9'14Utilities �'
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
—i- THIS BECOMES A PERMIT. '7 0
SEPA Checklist „ _,/� , 0 5-- 2'3 -7 9 2 6 8.7 Z *9. O d H
DATE OFFICIA CZ 0
APPROVED FOR ISSUANCE _