1979, 10-04 Permit: 79-5288 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
VALUATION Source GAS ELECTRIC WATT SEWER
of y
9, Utilities �`
Single $
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 Building
type of work will be complied with whether specified herein or not. The granting of a per it does not presume
to give authority to violate or cancel the provisions of any other state o cal law regula ' g construction or the
performance of construction. Plumbing
SIGNATURE
DATE � ? 21 / —
Mech.
Al I
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
DATE to/Zl' /4�OFFIC _ _. _..
PERMIT NUMBER
DAT
Ca* *9.0
*900
P
528,7
iQ-04-79
y 6,479.
TOTA L $ "
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-04-79 `�,;
APPLICANT:
COMPLETE NUMBERED SPACES —
PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION —SEE ATTACHED
1.
/O
a
LOT
--BLOCK
PARCEL NUMBER/S
2.
I
ISUBDIVISION
OWNER
-;7
P NE
3.
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
CON AC R
f
PHONE
Size of Parcel
Zone Classification
4'
A ESS
Z
Type Const.
Occupancy
Sprinklered
I
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE NEW
11 ALT.
D'N. ❑ RPL.
I ElMVE.
7,
OF
XECH;
El OTHER
F-1 BLD.
ElPLMB.
❑ M.H.
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
8.
DESCRIBE WORK
�.
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATT SEWER
of y
9, Utilities �`
Single $
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 Building
type of work will be complied with whether specified herein or not. The granting of a per it does not presume
to give authority to violate or cancel the provisions of any other state o cal law regula ' g construction or the
performance of construction. Plumbing
SIGNATURE
DATE � ? 21 / —
Mech.
Al I
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
DATE to/Zl' /4�OFFIC _ _. _..
PERMIT NUMBER
DAT
Ca* *9.0
*900
P
528,7
iQ-04-79
y 6,479.
TOTA L $ "
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-04-79 `�,;