1981, 06-04 Permit 81A-5475 1000 Gal Storage TankPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
PERMIT NUMBER
VALUATION
9.
4. ADDRESS
DESIGNER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS �+ '
1. 4�,T6BLOCK SUB � lod �i✓6.
3. XL.we �w�>�ivt i(I,A/ticrsh*/
DD�SS E Mi
� r r dv e.�_, "71/
CO TRACTOR
Sa/AC
S'QM4..
PHONE
ZIP
niZeZ
PHONE
ZIP
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
East
West
Zone
of Parcel Classification
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Building lding Area in Sq. Ft.
ADDRESS
Sat! e-
CHANGE OF USE FROM
6.
TO
ZIP
Main Floor
Area of Decks
Gar
age Floors Area
Finished Basement
Storage
Unfin. Basement
TYPE
7. OF
WORK
D NEW
❑ BLD.
❑ ALT.
❑ PLMB.
• AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK .,.,��,, _�
foi✓ • .Nt JD D ELStemC ,Zsia
SOURCE GAS ELECT WAT5R SEWER
OF
UTILITIES
Enum. Dist.
Ownership
Public ❑ Private ❑
Location (Area)
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION a"."'/1"/ SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buil Thiicla�h
SPECIAL CONDITIONS:
Lao r,9,je
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify).. -—
TOTAL
08* * 1 5.00
* 15.00 1-6
* 1 5,006
A *0,00 0
547,42
06-04-81
z 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'6;-0`4-8,1 547,•5'5- *15.002p