1979, 08-27 Permit: 79-2819 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER �y
H �. 2 I
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 I1
JOB ADDRESS 9
0 4 * * . 0 0
1. j' // LEGAL DESCRIPTION - SEE ATTACHED * 9,0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S i * 9,0 0 U
2. 7
OWNER P ONE/ A * 0.O
3. ' v k1'(T/�� U
ADDRESS i
ZIP Required Set Backs in Feet 2 8 1.8o North 'South East 'West
CONT TOR PHONE '/ Size of Parcel Zone Classification 0 8—2 7—7 9
4. z'(-.-) I % ‘74:-<—/ ,,,.S757:445-0.5
,,.'.S?5-'`.SU i 6 4 7 9.
AD ES `J ZIP-��� Type Const. Occupancy Sprinklered
/y ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area I Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE
❑ NEW ❑ ALT. IXD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ElPLMB. ECH: 0 M.H. ElPOOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK /.‘v : /✓^ FEES COLLECTED
8.
VALUATION Source /14-"It_...,L.ECTIC 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 perplit does not presume
to give authority to violate or cancel the provisions of any other state o .cal law regula • g construction or the
performance of construc 'on. Plumbing
= � q 9 �
DATE SIGNATURE / / „in/
, Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA <
1-
Planning —
Planning _ L
<
Mobile Home <
Fire Marshall
Co. Engineer Other(Specify)
Utilities
TOTAL $ �l�
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist '']] ` THIS BECOMES APE� 0 PERMIT. p
DATE��` / OFFIC L y —LL--7!
-- � 0 8 —'� / —/'7 7 2 19 Z
APPRO OR ISSUANCE 9. 0 0 a°