1979, 10-02 Permit: 79-5151 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
1.
LOT
2.
BLOCK
SULESI
ON
OWNER
3 ADDRESS
CO TRA TOR
4.�
a
ESS
. (3
DESIGNER
5' ADDRESS
rat,' c
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East 'West
PHON
Z I PctcW/
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area l Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
LJEW D ALT.❑AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. b42v1ECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
/ E CRIBE WORK
8.l eC
VALUATION
9.
Soirce)
of
Utilities
()�� ELECT IC R 1 �zl7l�
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 construction or the
performanceCof construction. �y
DATE + C50-r-�+ _
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. y
�1
ll
SIGNATURE
1\
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE
SO'
Io 2 / /OFFICIAL
APPROVED • ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing 2
Mech. r��
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 2160
.!!
PERMIT NUMBER
_s)5(
DATE
04* *21.00
*21,00 N
*21,006
B *0.00
51502
10-02-79
2 6479,
- L
WHEN MACHINE VALIDATED IN THIS SPACE,
THISITOI)(IF 1AF MIT.
515.15 .*21.002.