1979, 08-30 Permit: M79-3177 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 ADDRESS
5, 352) &J d7,
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
OWNER/
ADDRESS //VJ
SUBDIVISION
1:27-5{9.3-4
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South 1East 'West
5.
DESIGNER
•
V-506—
ZIPncRo7
PHONE
Size of Parcel
Type Const. Occupancy
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
8.
TO
Split Entry
Split Level
Rancher
O NEW
❑ BLD.
DESCRIBE WORK
O ALT.
❑ PLMB.
CJ AD N. 0 RPL. 0 MVE.
YECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
VALUATION
9.
Source
of
Utilities
GAS
ELECT IC
WATER
SEWER
I hereby certify that I have read and examined this applica ion and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . 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 1. a .w regulatinconstruction or the
performce of construction.
DATE o -&A 3 -77 SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
_ OFFICIAI
APPROVED OR ISSUANCE
r.
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
9�
TOTAL $47 �-
DATE
M
e' -as -77
PERT NUMBER
04* *9.00
*9.00 En
*9.008
A *Q00 8
3/17.6a
'08-30-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'08';130'7.79 3'17.72
ire
O
H-
U
W
Ct.
CO