1979, 10-02 Permit: 79-5147 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT P1 -0 x(47
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE j. edf' ,o, /rn
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HA PD TO MAKE 4 COPIES
JOB ADDRESS 04 * * 9,00
1. 6 // .2_o 7 9 '/:-(,tz, . LEGAL DESCRIPTION — SEE ATTACHED
* 9 p p
175
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. * 9.00
OWNER � o PHONE B * 0 0 0 U
3. ��- -�-. eg, p' Z.-/- .�Zr'-'t., 9 '71-....506.5
ADDRESS ZIP Required Set Backs in Feet 5 1 4 6
,�Zd.�2..C��. North 'South East (west 1 0-0 2-7 9
CONTRA TOR
TOR PHONE Size of Parcel Zone Classification
4. ` pe-- -e _P�/ _9018-/J a/ 6.4 7 9.
ADDRESS ZIPType Const. Occupancy Sprinklered
} /QV'V/dc•e./-44;e4/J ,/ 7/9/9A-?—02C� 7/9 O ❑Yes No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area r 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. 0 RPL. 0 MVE.
7, OF 0 OTHER
WORK 0 BLD. 0 PLMB. X MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. . , y/ - 7 FEES COLLECTED
VALUATION /` Source GRS ELECTRIC 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 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
1--
Planning U
— ti.!
Fire Marshall Mobile Home vn_)
Z
Co. Engineer Other (Specify)
Utilities 9�
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ,, c THIS BECOMES A PERMIT.
DATE'(/'2/7 u [ _ J 9 � 7 it * 9. n Oa . 1-2
APPRI+ : FOR ISSUANCE