1979, 09-20 Permit App: 79-4406 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 TO MAKE 4 COPIES
JOB ADDRESS
f 0 `�dn �p L�*_`� LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK S BDIVISION PARCEL NUMBER/S
2.
North South
East West
Size of Parcel
OWNER � (�
%��
PHONE
3. �
Sprinklered
ADDRESS � � � .�
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1i��C1X1
Building Area in Sq. Ft.
ZIP
CONTRACTOR
DWL Area
Basement Area
PHONE
0
a 0�
4.
Split Level
Rancher
ADDRESS
ZIP
DESIGNER
No. Rooms
Rec. Room
PHONE
CERTIFICATE
5. ADDRESS
I Recd.
Not Rec
ZIP
CHANGE OF USE FROM
TO
6.
TYPE liQ_ NEW ❑ ALT. ❑ AD'N.
❑ RPL.
❑ MVE.
% OF
ElBLD. 13PLMB. ff MECH:
ElM.H.
11POOL ❑OTHER
WORK
DESCRIBE WORK
la",
8. )P--
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Requirea Set Backs in reet
North South
East West
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
I Recd.
Not Rec
of EXEMPTION
FEES COLLECTED
VALLtArrION Source GAS ELECTRIC WATER SEWER
of
9, Utilities X X 1 1 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-\) a1 �Q Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
nr DT RFrYn RFcIn_ I Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
M -11-+ o�o
DATE (-1-7— 7 c,
04* *9,00
*9.00
to -
9.
E *000 00
44Q5;9
09-20-79
;1 6479,
/� C�� I WHEN MACHINE VALIDATED IN THIS SPACE,
j 1/ ' THIS BECOMES A PERMIT.
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W
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DATE
REMARKS
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY