1979, 10-04 Permit: 79-5284 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
Ai cyek
SPOKANE COUNTY - BUILDING CODES DEPARTMENT c� -- c�2i
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE ( 'R� 77
APPLICANT: COMPLETE, NUMBERED SPACES - PRESS HAii3 TO MAKE 4 COPIES 0 4 * * 9.0 0
JOB ADDRESS /7? 0 [ Cy f{' * 9.0 0 u)
��1. l/aj/ '_ LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISI N PARCEL NUMBER/S * 9.0 0 U
2. B * 0,00
OWNER 1 ` / P N_
' �a�� 5283-2
3. ADDRESS // ZIP Required Set Backs in Feet
North 'South East 'West 1 0-0 4-7 9
CONT-4.4 OR — PHONE Size of Parcel Zone Classification 4 7 9,
4. ADDRES '/ / ZIP Type Const. Occupancy Sprinklered
. �c 057 -1 9? o7' ❑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
6.
/ No.Baths No. Floors No. Rooms Rec. Room
TYPE
❑ NEW ❑ ALT. E AD'N. ❑ RPL. ❑ MVE.
7. OF OTHER
WORK ❑ BLD. ❑ PLMB. Er
MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK ��n 4,.
8 . /; A- ., .� FEES COLLECTED
VALUATIO /� //'Source GAS ELECT I 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. The granting of a perm' does not presume
to give authority to violate or cancel the provisions of any other state or loc- law regulati . constructs• or the
performance of construction. Plumbing
DAT "'"?y-- 7 " SIGNATURE l gid,, Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA =.)
Planning — lava
2
Mobile Home
Fire Marshall
Co. Engineer Other(Specify)
Utilities TOTAL $ 7Gld
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMS A PER MIT.
uE7 L U.,l. `. * Q. U U C
DATE IV?
OFFICI
APPROVOR
ISSUANCE —