1979, 08-07 Permit: 79-1659 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
1.
2.
3.
JOB ADDR SS ps %,I y'
LOT L SL�BDIVISIOty 5_ Q
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER
ADDRESS
rde..y1 CO/ -1,5" 611
CONT ACTOR G� y
4. %��%L�al�i�`✓
DRESS
PHONE
9�v9202
ZIP
Required Set Backs In Feet
North ,South ,East (West
PHONE
92 -?-02/ oU
Size of Parcel 1 Zone Classification
DESIGNER
ZIP
PHONE
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
OWL Area
'Basement Area ` Garage Area Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW ❑ ALT. 0 AD'N. i11 RPL. 0 MVE.
❑ BLD. 0 PLMB. gl MECH. 0 M.H. ❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUA ION
9.
Sour
of
Utilities
GAS
ELECTRIC
WAVER
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 copstruction or the
performance of construction.
DATE
SIGNATUR
SPECIAL APPROVALS
DEPT. 4 REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE87y79"
"( �
OFF(Il,
/// •
APPRI r D FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
06)
/Yrv/ Ad mp/ bd
OtheriSpeeifylEl
TOTAL $ J C C�
DATE
PERMIT=UMQER^�
04*
*9.00
*9.00 n
*9.006
A *000 S
165,82
08-07-79
f 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS COM APE MIT.
(�6 -0 7 -7 165.911