1979, 10-04 Permit: M79-5278 Heat Pump, FurnacePLAN 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
2.
JOB ADDRESS '�/J�
LOT
BLOCK SUBOI ISION
DESIGNER
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER'S
Required Set Backs In Feet
North South East 'Wes
Size of Parcel
Type Const.
Valuation
Occupancy
Zone Classification
Sprinklered
DYes DNo 0 Req'd.
Building Area In Sq. Ft
ADDRESS
ZIP
D W L Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
SRI it Ent
Y
Split Level
Ranche
TYPE
7. OF
WORK
O NEW
O BLD.
O ALT.
O PLMB.
9ftJ N. 0 RPL.
MECH: 0 M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd
Not Req'd.
DESCRIBE W
8.
®-:6
VALUATION
9.
Sour 7nnynic
of
Utilities
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 p= mit does not presume
to give authority to violate or cancel the provisions of any other state or 1.,alaw regu .ting const,, tion or the
performce of construction.
DATE
DEPT.
' SPECIAL APPROVALS
REO'D. REC'D
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilitie
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
OFFICI
APPR
OR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. /3 t)
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $/
DATE
PERMIT NUMBER
�- t5 7
04* *1300
* 1300 N
* 130.0
B *000
527.7@
10-04-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B CO AP MIT.
.1U�;U 77i 5;2117.85
*1 3. 0,0 LL F