1979, 11-15 Permit: 79-7850 Heat PumpFtl_AN 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
1.
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
8 4 " -
�
VALUATION Source
GAS
ELECTRIP
OWNER
�
PHONE
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
ADDR
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
ZIP
Required Set Ba
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
Plumbing
performance of construction.
North
DATE SIGNATURE _ Mach.
CONTRT O.R
SPECIAL APPROVALS SPECIAL CONDITIONS:
PHONE
Size of Parcel
4'
Env. Health
ZIP
Type Const.
ADORES
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities "
DESIGNER
TOTAL $ /
PHONE
Valuation
5.
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE 1///✓//-/ OFFI CIAI -- --
ADDRESS
ZIP
DWL Area
CHANGE OF USE FROM ITO
6.
I YPE ❑ NEW ❑ ALT. �AD'N. ❑ RPL. ❑ MVE.
7, OF ��11 OTHER
Min DV El BLD. ElPLMB. 5KMECH: ❑ M.H. ❑ POOL
eet
e
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Basement Area Garage Area Storage
Split Entry Split Level Rancher
No. Baths No. Floors No. Rooms Rec. Room
CERTIFICATE Req'd. I Recd. Not Rec
of EXEMPTION
A ^ PERMIT NUMBER -7
A \
DATE
DESCRIBE WORK
� FEES COLLECTED
2�4
8 4 " -
�
VALUATION Source
GAS
ELECTRIP
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 _ Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities "
TOTAL $ /
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE 1///✓//-/ OFFI CIAI -- --
-