1979, 12-07 Permit: M79-8822 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD T9 MAKE 4 COPIES
PERMIT IUMBEFj,
1 - c zz
DATE
1.
2.
3.
JOB A D D R S //y�J.///�'
/5 �._/`� / / 1�•
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
M%- >. 741 5- &/1 y
A�` 3
PHONE
J
PARCEL NUMBER/5
ADDRESS
rLRJ
ZIP
CONTFFAC OR
E=55
4. ADD
PHONE
Required Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
ZI
9ae
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area I Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
• NEW
❑ BLD.
❑ ALT.
❑ PLMB.
AD'N.
MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
DESCRIBE WORK
VALUATION
Source
of
Utilities
GAS
ECT IC
WATER
SEWER
hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
pe of work will be complied with whether specified herein or not. The granting of a permit does not presume
give authority to violate or cancel the provisions of any other state or local law regulating construction or the
rformance of construction.
DATE 0/0V/29
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATUR
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL 'ONDITIONS:
DATE /2---7— 7'OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Ot
Mech. LG.00
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $q.00
2?
u4*
*9.00
*9.00
*9.006
E *000 0
88212
12-07-79
2 679,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOME5 A PERMIT.
12 0 79
882.22
*9.00°-1
INQDC!`TflD