1979, 12-07 Permit G79-8814 Oil 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
LOT
BLOCK
OWNER
ADDRESS
CO yRACT
-15. y
4. ADDRESS
/V' /6/ 1/
SUBDIVISION
DR
r (, r- L- 7
, . I O t 1
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
O NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
J �kr J C7��J
ZIP �J2( )!
PHONE
ZIP
PHONE
ZIP
TO
❑ AD N.
0 MECH:
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North (South (East
Size of Parcel
Type Const.
Occupancy
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
DWL Area
Basement Area Garage Area
Split Entry
Split Level
- DfSCRIBE WORK
VALUATION
9.
Source
of
Utilities
GAS
ELECTR IC
No. Baths
No. Floors
CERTIFICATE
of EXEMPTION
7 ! —7—;--/ irk F..
WATER
No. Rooms
Req'd.
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 /• /J`/• SIGNATURE ���—'�r�����.r�
DEPT,
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE/ ?' 7 9‘
OFFICIAL
Storage
Rancher
IRec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
�V PERMIT 'l� R
DATE 7(%
04* *9,00
* 9.0 0 tri
*9.006
E *0,00
881.32
12-07-79
2 6,479.
„
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A P j3MIT. 3 Q L^ d
*9,00°+
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