1979, 08-27 Permit: 79-2797 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 A
1.
LO
2.
rRE77�/�
BLOCK SUBDIV I N
LEGAL DESCRIPTION — SEE ATTACHED
3
4.
OWNER/
ADDRE
CON
ADDR j
P NE
Z.97-20 6
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.
DESIGNER
5. ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area ( Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
8.
9.
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
DESCRIBE WORK
VALUATION
O ALT.
❑ PLMB.
11.<5 ❑ RPL. 0 MVE.
MECH: 0 M.H. ❑ POOL
Source
of
Utilities
0 OTHER
�L�CTRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
WATER
CERTIFICATE
of EXEMPTION
SEWER
Req'd.
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 lo law regulati : 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:
DATE
OFFICI
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. J ' crO
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ `:°
DATE
PERMIT NUMBER
— X797
g* -i 77
04* *9.00
* 9.00
* 9.00'6
A *0.00
279.62
08-27-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISTr fOry A �E�iMlT. L/ 7 r
*7.UU F-