1979, 10-04 Permit: M79-5282 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASNGTON 99260 / (509) 456-3675
1.
JOB ADDRESS
LOT
BLOCK
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
75 29
SUBDIVISION
2.
3.
OWNE
ADDRESS
CONTRp OR
4. A6D E _ / V/3t- �4, i liC�
DESIGNER (/j
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East 'West
PHONE
o
Size of Parcel 1 Zone Classification
5' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
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
TO
Split Entry
Split Level
Rancher
❑ NEW
0 BLD.
O ALT.
O PLMB.
'N. ❑ RPL.
MECH: ❑ M.H.
❑ MVE.
O POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
GAS ELECTFi
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 %'.es not presume
to give authority to violate or cancel the provisions of any other state or Igo w jegulatinonstruction r the
performan of const ction.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
de
TOTAL $
1'1
PERMIT NUMBER
522
DATE
04* *9,00
*9.00 tr
*9,005
B *0.00 0
528, 1 2
10-04-79
6, 4 7 9,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-04'-79
5.28.2 *9,00
INSPF1 TOO