HomeMy WebLinkAbout1979, 09-21 Permit: 79-4503 Water Heater, PipingPLAN 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
JOB ADDRESS
�. // LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/5
OWNER
3.
ADDR SS
// a? y
CONTRACTOR
4' A fl
ADDRESS
DESIGNER
R
ADDRESS
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/ �- 4/ At, i
CHANGE OF USE FROM TO
6.
PHONE
ZIP 99PHONE"Ae
ZIP
FIA
PHONE
ZIP
— LJ NEW ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
)rth ISouth
East West
ze of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
SEWER
9.
❑Yes ❑No ❑ Req'd.
duation Building Area in Sq. Ft.
DWL Area Basement Area Garage Area Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
Recd.
Not Req'd.
of EXEMPTION
performance of construction. Plumbing
DATE / —�� — % SIGNATURE G`tc--
PERMIyi NUMtPWR
?9- �c5 :0 ::�]
DATE 9" �' 7f
04* *1200
* 1 2,00
*120061
E *0,00 00
4502-4
09-21-79
9 6479,
$• &17 FEES COLLECTED
VA ATION
Source
of
GAS
ELEC I
WATER
SEWER
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
DATE / —�� — % SIGNATURE G`tc--
Mech.. L/G�
SPECIAL APPROVALS SPECIAL CONDITIONS: "0
DEPT. REQ'D. REC'D. i, Plan C eck
Env. Health
c , yr
Planning v SEPA
Fire
Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
SEPA Checklist
IN THIS SPACE,
THIS BECOMES A PERMIT.
_290FFICIAZ" 2 i 9
DATE da4tt4 _ J 7—,
APPROVED FOR ISSUANCE
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