1979, 08-27 Permit: 79-2855 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 ADDRES
LOT
BLOCK
3
3
S DIVISION
OWN S L'"�' SOL%[�'G���
3
ADDRESS
4.
CONT
ADD'
DESIGNER
v(i
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
.*5655
ZIP
PHONE /
PHONE
P ab7
ZIP
TO
I/CAD N. ❑ RPL.
1{14...rCH: ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
DESCRIBE WORK
VALUATION
9.
Source
of
Utilities
GAS
EL CTRIC
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North South East West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
DWL Area
Basement Area
Split Entry
No. Baths
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
WATER
SEWER
Storage
Rancher
No. Rooms
Req'd.
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 al law regula ''g constructio .r the
perfornce o construction.
/�- 7�
DATE S SIGNATURE
ir
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
9
OFFIC
APPRO
=9--F/OR ISSUANCE
Rec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
-
DATE
04* *9.00
* 9.00 U)
* 9.006
A *000
285,4-2
08-27-79
2 6479.
—
G
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-2'7-79
285,55 *9,00
O J