1979, 08-24 Permit: 79-2825 Heat PumpPLAN NUMBER
APPLICATIOWPERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
Z
tj77 DATE '/ / — l
04* *9,00
*9.00 N
*9.006,
A *0.00 00
2824-4
08-27-79
2 6479.
VALUATION t Source GASJ— ELECTRIC WATER SEWER
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRES
''
�j✓�
LEGAL DESCRIPTION - SEE ATTACHED
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
LOT
BLOCK
Building
PARCEL NUMBER/S
2.
I
ISUB01VISION
to give authority to violate or cancel the provisions of any other state or c I law regul ting construction or the
OWNER
Jq
performancet of construction.
PHON p
3.
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9 co
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DATEN SIGNATURE
ADDRESS
ZIP
Required Set Backs in Feet
DEPT. REQ -D. RECD.
North South
East West
CONTRACTOR
PHONE J
Size of Parcel
Zone Classification
SEPA
5
4'ADDRESS
a
��
Mobile Home
ZIPC9/
/�
Type 7�ccupancy
Fire Marshall
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
Co. Engineer
PHONE
Valuation
Building Area in Sq. Ft.
5'
f
TOTAL $
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
WHEN MACHINE VALIDATED
SEPA Checklist THIS BECOMEv.kjS�A PERMIT.
?
`��c_ —�
DATE L' �OFFICI
`Ui/
�(d�
APPRO FOR ISSUANCE
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths No. Floors 1 No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. AD'N.
❑ RPL. ❑ MVE.
7,
OFElOTHER
El BLD. ElPLMB. MECH:
ElM.H. El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
8.
PERMIT NUMBER
Z
tj77 DATE '/ / — l
04* *9,00
*9.00 N
*9.006,
A *0.00 00
2824-4
08-27-79
2 6479.
VALUATION t Source GASJ— ELECTRIC WATER SEWER
of �%
9. Utilities
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 p rmit does not presume
to give authority to violate or cancel the provisions of any other state or c I law regul ting construction or the
performancet of construction.
Plumbing
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9 co
�»
DATEN SIGNATURE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ -D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
f
TOTAL $
Zone Clearance
IN THIS SPACE,
�j
WHEN MACHINE VALIDATED
SEPA Checklist THIS BECOMEv.kjS�A PERMIT.
?
`��c_ —�
DATE L' �OFFICI
`Ui/
�(d�
APPRO FOR ISSUANCE