1979, 09-10 Permit: M79-3669 Heat PumpPLAN NUMBER
JOB ADDR
1.
3. l/ i yr .
ADDRESS
con c
R ESS
.` 12
DESIGNER
5. ADDRESS
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
LEGAL DESCRIPTION — SEE ATTACHED
CHANGE OF USE FROM
6.
PHON
��
ZIP
ZIP
9�
PHONE
ZIP
TYPE ❑ NEW ❑ ALT. O-AD'N. ❑ RPL. ❑ MVE.
7 OF WORK El BLD. ❑ PLMB. MEC ❑ M.H. ❑ POOL 1:1 OTHER
DESCRIBE WORK.
8.✓�'!/�
ee
ize of Parcel -
Zone Classification
S
ELECTRIC
Type Const.
Occupancy
Sprinklered
hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
[]Yes [--]No ❑ Req'd.
'aluation
Building Area in Sq. Ft.
to give authority to violate or cancel the provisions of any other state or I al I w regu ting cons ction or the
DWL Area
Basement Area
Garage Area
Storage
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:.
Split Entry
Split Level
Rancher
SEPA
Planning
No. Baths
No. Floors
No. Rooms
Rec. Room
Co. Engineer 4r"
Other (Specify)
Utilities
CERTIFICATE
Req'd.
I Recd.
Not Rei
of EXEMPTION.
WHEN MACHINE VALIDAT
SEPA Checklist �'7'�,,
Q
FEES COLLECTED
VALUATION
9,
Source
of
Utilities
S
ELECTRIC
WATER
SEWER
Single $
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
Building
type of work will be complied with whether specified herein or not. The gra . g of a permit does not presume
to give authority to violate or cancel the provisions of any other state or I al I w regu ting cons ction or the
perform ce o -construction.
Plumbing
DATF �� SIGNATURE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:.
DEPT. REQ'D. RECD.
Plan Check
Env. Health _..
SEPA
Planning
/`
Mobile Home
Fire Marshall
Co. Engineer 4r"
Other (Specify)
Utilities
TOTAL $
Zone Clearance _
WHEN MACHINE VALIDAT
SEPA Checklist �'7'�,,
Q
ES A PERMIT.
THIS BECOMES
O l.r'll 0?F3 / 7 .,9
0FFICIAi G�
DATE�
APPROVED FOR ISSUANCE
PERMIT NUMBER
DATE
04* *900
*9,00 N
*•9.00Y
E *a00
82.
09-1&-79
;2 6479.
316:,6,92 *9,00ai-
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