1979, 11-26 Permit: 79-8315 Heat Pumpr
.AN NUMBER
Ili
ii NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
if APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
1.
2.
JOB ADDRESS
' (\'3 3.o Fp A.1cktrOSA
LOT BLOCK UBDIVISI N
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/5
3
4.
5.
OWrjE2
AD�3 ED RA;VsoM 6 tcIV'
ijES5c115 P%�ves R�_ Sr-FJ��mut
G NTRACTO3t QL4A-tcfy R EA-t/tic-
ADG/tT5(o2 710 .1-41DfA-/6/
DESIGNER
HONE
ay -;2033
zt 1:06
gPHONE
Required Set Backs in Feet
North 'South East 'West
Size of Parcel 1 Zone Classification
ZIP
PHONEPHONE
Type Const.
Occupancy Sprinklered
❑Yes ❑No 0 Req'd.
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
OF
WORK
❑ NEW 0 ALT. }}❑yy AD N. 0 RPL. ❑ MVE.
yg.
❑ BLD. 0 PLMB. MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
9.
DESCRIBE WORK
M7 (+CA -T
VALUATION
'UMP 7o & Os'r/A & Fu leil.%a-CE
Soure GAS ELECTRIC WATER
of -
Utilities
SEWER
I hereby certify that I have read and examined this applica ion.and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . 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 local law regulating construction or the
performance of construction. �y,(t ���}/��Q--r,-��
DATE —�i �79 SIGNATOR �/'�^��`^��`�—
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
F-AudizAdt_ .50,000 ern!,
DATE 'OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
. P-mnr3i00
Mecb.f e _-b. 1411)
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
M
PERMIT NUMB R
Ct 31 j
DATE
04* *•9.00
*9.00 t5
*9.006
6 *000 8
831.48
11-26r79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE, 0
THIS BECOMES AI'9' O L/ PERMIT. 83� Z 7. 0101
oalH
11-2'6'-;7 7
APPROVED FOR ISSUANCE -
CC
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