1979, 12-05 Permit: 79-8714 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 -
A/,;- �t l��j� LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION I PARCEL NUMBER/S
2.
Required Set Backs in Feet
❑ RPL.
❑ M.H.
c �C
O NER
East West
PHONE
3. c� < < R
Zone Classification
CERTIFICATE
ADDRESS-
Recd.
ZIP
/ 0 -j e , "
/00
/lot,
"TRAC OR
�-v>
F
.�
4. ADDRESS
%A/
5. ADDRESS
CHANGE OF USE FROM ITO
6.
PHONY'
ZIP
Required Set Backs in Feet
❑ RPL.
❑ M.H.
c �C
North South
East West
PHONE
Size o6 Parcel
Zone Classification
CERTIFICATE
Req'd.
Recd.
ZIP
Type Const.
Occupancy
Sprinklered
of EXEMPTION
I
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP DWL Area I Basement Area Garage Area Storage
Split Entry Split Level Rancher
No. Baths No. Floors No. Rooms Rec. Room
_jA jPE3fqNgjR,
DATE
04 *9,00
* 9.0 0
*9.0061
E *000
871.32
12-05-79
6.479.
TYPE I] NEW
7, OF
1:1 BLD.
❑ ALT. ❑ AD'N.
❑ PLMB. O MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ OTHER
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCIBE WORK
8.
/
J
% FEES COLLECTED
VALUATION
GAS
I ELECTRIC I WATER SEWER
Of
9. 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
Plumbing
performance of construction.
DATE �)SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $ r/•
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS B CO A MIT. ,j
DATE` OFFICIAL '�" 1..4 z
Annnnvrn rnn iooiinRif, r
*9.00°