1979, 08-09 Permit: M79-1910 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
//d 0730
LOT ffLOCK SUBDIVIS ON
3.
4.
OWNER
ADDRESS
CONTRACTO
ADDRESS'
DESIGNER
5. ADDRESS
PHONE
ZIP
PHONE
—.1/6"--10;
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
ZI P
TO
EVAD'N. ❑ RPL.
0 M.H.
MEC H:
O MVE.
O POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North South
Eas
Size of Parcel
Type Const.
Occupancy
West
Zone Classification
Sprinklered
❑Yes ENo ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area
Split Entry
No. Baths
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
Storage
Rancher
No. Rooms
Req'd.
Rec. Room
Rec'd.
No
Req'd.
DESCRIBE WORK
VALUATION
9.
Source
of
Utilities
SKAS
ELECTRIC
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 permit does not presume
to give authority to violate or cancel the provisions of any other state or local law r•gulating construction or the
performance of construction.
DATE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DAT
OR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
e9.0
n
DATE
PERMIT NUMBER
- 7C7
04*
A
190,92
08-09-79
2 6479,
* 9.00
* 9.00
*9.006
*0.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-09-79
1910
*900
O J
I L