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1979, 09-12 Permit: 79-3840 Heat PumpPLAN NUMBER 't. 4 APPLICATION/ PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DESCRIBE WORK 8 p DkK FEES COLLECTED DATE PERMITNUMBER '"- 38 40 04* *7.00 *7.00 15- 7. 0 0 7,00 A *a00 3839@ 09-12-79 ;R 6479. VALUATION APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES ELECTRIC JOB ADDRESS SEWER LEGAL DESCRIPTION — SEE ATTACHED ,. ILUs of Utilities LOT 6LOCK Single $ PARCEL NUMBER/S 2. ISUBDIVISION 1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included OWNER PHONE -MAO W' type of work will be complied with whether specified herein or not. The granting of a permit does not presume 3. Wit performance of construction. Plumbing ADDRESS DATE SIGNATURE— ZIP Required Set Backs in Feet SPECIAL APPROVALS 57 S P D a North South East West CONTRACTOR PHONE Size of Parcel Zone Classification V Planning 4. DRES ADSr Zi Type Const. Occupancy Sprinklered Fire Marshall SPo 111)e 9,-209 ❑Yes ❑No ❑ Req'd. DESIG14ER Utilities PHONE Valuation Building Area in Sq. Ft. 5' WHEN MACHINE VALIDATED IN THIS SPACE, ADDRESS t THIS CO A EijiMIT. R 4.0 Z ZIP DWL Area Basement Area Garage Area Storage CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. No. Baths No. Floors No. Rooms Rec. Room TYPE NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7, OF El BLD. 11 PLMB. Y-MECH: EI M. H. ❑ OTHER El POOL CERTIFICATE Req'd. Rec'd. Not Req'd. WORK of EXEMPTION DESCRIBE WORK 8 p DkK FEES COLLECTED DATE PERMITNUMBER '"- 38 40 04* *7.00 *7.00 15- 7. 0 0 7,00 A *a00 3839@ 09-12-79 ;R 6479. VALUATION Source GAS ELECTRIC WATER SEWER 9, of Utilities Single $ 1 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 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 performance of construction. Plumbing DATE SIGNATURE— Mach. OD SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. RECD. Plan Check Env. Health SEPA Planning Mobile Home Fire Marshall Other (Specify) Co. Engineer Utilities _ TOTAL $ 111 60 ------ss��--------- Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist a `� 12 79 0FFI DATE OFFICIAL ^A ,w. ^^ THIS CO A EijiMIT. R 4.0 Z *7.00a r-