1979, 12-06 Permit: 79-8750 Water Heater PLAN NUMBER APPLICATION/PERMIT PERMITG - CNUMBER]
SO
SPOKANE COUNTY — BUILDING CODES DEPARTMENT l l
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE f-7 ' ' 79
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
i4 * * 1200
JOB ADDRESS _ Te LEGAL DESCRIPTION — SEE ATTACHED * 1 2 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 2 0 0
2.
OWNER PHONE E * a0 0 8
3. ,dab eS/re e e/-
ADDRESS ZIP Required Set Backs in Feet 8 7 4.9 g
Sq WV, North (South East (West 1 2—0 6—7 9
CONTRACTOR PHQ E/ Size of Parcel Zone Classification
4. 6i N NeiT/N7 7/ ii—�07� 2 6479,
ADDRESS ZIP Type Const. Occupancy Sprinklered
A/3063 C/j //AJE 99.20'7 ❑Yes ❑No ❑ Req'd.
DESIGNER [ PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I 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. i MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WO.:;
8. .:5),.5
[ I 'k // 0 r `e71T FEES COLLECTED
VALUATION f Source GAS ELECTRIC/ WATER SEWER
of i��/
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 the
performance of construction. Plumbing
,1 1111
DATE ta-�-7 j SIGNATU'' 2' �-- * Mech. /Z•
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. 1t Plan Check
i i
Env.Health 00o1,� _ f
SEPA
I—
Planning
C..7
Planning — w
4
Mobile Home c/)
Fire Marshall z
Co. Engineer Other (Specify)
Utilities
TOTAL $ /Zt.- ----
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES AIT:MIT. / n (1
DATE i/Z-5-7OFFICIAL `(}}I. 2 U U.--!°7 1 7. 0 * 1 2, U U 2 F J
APPROVED FOR ISSUANCE _