1979, 08-27 Permit: M79-2829 Heat PumpPLAN NUMBER
APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT M 79- 202-W
DATE — i
04* *900
*9.00 N
*9.006
A *000
28282
08-'27-79
2 6479.
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
2.
3.
4.
5.
JOB ADDRESS; /Q/
SUBDIVISION
LOT
BLOCK
OWNER
ADDRESS/�(���/J
CONTR
'
A• DRESy cO3
DESIGNER
LEGAL DESCRIPTION — SEE ATTACHED
P-770/
ZIP
PH NE
PHONE
PARCEL NUMBER/S
Required Set Backs In Feet
North 'South (East 'West
Size -of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area In Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM
8.
TYPE
7. OF
WORK
8.
9.
I:1 NEW
❑ BLD.
DESCRIBE WORK
VALUATION
❑ ALT.
❑ PLMB.
TO
iLH A� N. ❑ RPL.
M//ECH: ❑ M.H.
iieta
Source
of
Utilities
GAS
Split Entry
Split Level
Rancher
❑ MVE.
❑ POOL
0 OTHER
TRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
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 per r' does not presume
to give authority to violate or cancel the provisions of any other state or al law regula • g construc>n or the
performancj-of construction.
DATE
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
9
OFFIC
APPRFOR ISSUANCE
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. /'
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS6ItCOr A, E,)2MIT.
28292 *9,00