1979, 08-13 Permit: 79-2055 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT �j''
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 111" Jt
DATE a V
ar
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB P) DR 5 G O4 * * 9.00
/� �, D LEGAL DESCRIPTION - SEE ATTACHED * 9.0 0
in
1 LO BLOCK SUBDIVISION PARCEL NUMBER/S
2.
* 9,00
A
OWNER - ! 41-610-4---y //%P_�,PHOUE A * 0 0 0 0
3 ADDRESS /IJ ZIP ry� Required Set Backs in Feet 2 0 5.4
✓��� North (South East (West O
CONT OR P ON �,- Size of Parcel Zone Classification 0 8— 1 3—7 9
4. �4 ,"/ � � g 6479,
D ESS / / / Z Type Const. Occupancy Sprinklered
0' Dyes ❑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
6.
TYPE No. Baths No. Floors No. Rooms Rec. Room
❑ NEW ❑ ALT. Q� N. ❑ RPL. ❑ MVE.
7. OF 1 ❑ OTHER -
WORK ElBLD. 1=1PLMB. 1[J MECH. 1=1M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
..)
of EXEMPTION
DESCRIBE WORK
8. FEES COLLECTED
VALUATION Source GAS ' LEC"IT C WATER SEWER
of �
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. T e granting of a permit does not presume
to give authority to violate or cancel the provisions of any other stat: . local law r-sulating construction or the
perfor ance of construction. 1 Plumbing
Q77 i
DATE —Cg'
SIGNATURE / �CLaJ ' Mech. .-SPECIAL
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
rr
SEPA Q
I-
Planning U
_ w
Fire Marshall a.
Mobile Home c
—
Co. Engineer Other(Specify)
Utilities
TOTAL $ e
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist % _\-.-----"—)J THIS BECOMES A PERMIT.
DAT 6 3 7/ OFF IAL L' ! "� 1. i _ _ ) J * / %' _
APP WV : OR ISSUANCE