1979, 08-27 Permit: 79-2865 Heat PumpPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
M -%7� y
DATE _ 9!/G —519
04* *9.00
*9.00
*9,00,
A *0.00
2864
08-27-79
2 6479.
VALUATION
9,
APPLICANT:
COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
I ELECTBlc
JOB ADDRESS
SEWER
Single $
LEGAL DESCRIPTION -SEE ATTACHED
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 I I law regulatin construction or the
LOT
BLOCK
performance of construction.
— SIGNATURE—
PARCEL NUMBER/S
2.
I
ISUBDIVISION
DEPT. REQ'D. RECD. Plan Check
Env. Health
OWNE
Planning
P ON
Mobile Home
3
Fire Marshall
Co. Engineer Other (Specify)
�
Utilities 6f7
ADDRESS
Zone Clearance
ZIPJ.�2
Required Set Backs in Feet
WHEN MACHINE VALIDATED
SEPA Checklist ` THIS BECOMES A PERMIT.
DATE OFFICI
North South
East West
CO TOR —
PHONE_Size
of Parcel
Zone Classification
4'
ADD
ZIType
Const.
Occupancy
Sprinklered
❑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.
Baths
No. Floors
No. Rooms
Rec. Room
TYPENo.
❑ NEW ❑ALT.
L�YAD'N.
❑ RPL. ❑ MVE.
7,
OFr/
BLD. ❑ PLMB.
1:1p
CJ MECH:
❑ OTHER
❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
�,
- e
FEES COLLECTED
PERMIT NUMBER
M -%7� y
DATE _ 9!/G —519
04* *9.00
*9.00
*9,00,
A *0.00
2864
08-27-79
2 6479.
VALUATION
9,
Source
of
Utilities
GAS
I ELECTBlc
WATER
SEWER
Single $
1 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 I I law regulatin construction or the
Plumbing
performance of construction.
— SIGNATURE—
DATE / _ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
�
Utilities 6f7
TOTAL $
Zone Clearance
IN THI
WHEN MACHINE VALIDATED
SEPA Checklist ` THIS BECOMES A PERMIT.
DATE OFFICI
APPROVE6'FOR ISSUANCE
PACE,