1979, 11-16 Permit: 79-7983 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
04 * * 9.00
JOB ADDRESS
/L/}-. vfilI��/f.REST�`— LEGAL DESCRIPTION - SEE ATTACHED * 9,0 0
1 LOT 170.CK. DIVISION PARCEL NUMBER/S ,k 9 0 Q
2.
OWNER PHONE E * Q 0 0 (.
3. Ziniihi USELMRd 9c26- 1)3 79 & 2
ADDRESS ,p C /ZIPP Required Set Backs in Feet
S.171 . VERAC_RES " %9/237 North 'South East (West 1 1 — 1 6-7 9
CONTRACTOR PHONE Size of Parcel Zone Classification
A-1 HER'ri Ali 0 Al2/COW). 4489-95V 6 4 7 9,
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
E. . WO LE "0g' ❑Yes ❑No ❑ Req'd.
DESIGNER l�/ 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
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. L MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. A o p v N i'-)-E PVT P'k- "' FEES COLLECTED
VALUATION Source G S ELECTRIC WATER SEWER
of
9. Utilities XX
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 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. Plumbing
DATE SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA o
Planning — U
w
a
Mobile Home
Fire Marshall - z
Co. Engineer Other(Specify)
Utilities
TOTAL $ .co
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES[ A PERMIT.
DATE 41\\b\111 OFFICIAL Al . &v� U 11 -1 -7'9%; Q l), ,* %. C i) (l
APPROVED FOR ISSUANCE _