1979, 08-09 Permit: 79-1912 Heat PumpPLAN 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 ADRES
1. iii C4 AAI
L
2.
SUBOTVTSION
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
O ALT.
❑ PLMB.
ZIP
TO
IAD N. 0 RPL.
E MECH: 0 M.H.
❑ MVE.
❑ POOL
0 OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East
Size of Parcel
Type Const.
Valuation
Occupancy
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area In Sq. Ft.
DWL Area
Split Entry
Basement Area
Garage Area
Storage
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
ELECTRIC
/(
WATER
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 to •I law regulating construction or the
performance of construction.
DATE. — 9-77 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATES "(19 OFFIr
APPRO
FOR ISSUANCE
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ (j-°
/1
DATE g— 7_ 29
PERMIT NUMBER
79-19t�-
04* *9,00
*9.00
*9.00
A *Q00 U
191.1
08-09-79
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIgcory A PE„itMIT.
19L2Z *9.00a1-2
DATE
1
RECORD OF INSPECTIONS
Final Inspection
REMARKS INSPECTED BY
08 -Cd -1d
t-tjJ
*GO S
(r
*60C