1979, 07-12 Permit App: 79-423 Heat Pump, FurnacePLAN 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
1.
2.
3.
JOB ADDRESS
LOT BLOCK SUBDIVISION /
OWNER -771,L10-& g -e/L-71-/
ADDRESS
PHONE
92«�,
ZIP
CONTRACTOR
174 (V_ i
ADDRESS
/ 71Q o�c/
DESIGNER
PHONE
ZIP _/6
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North South East
Size of Parcel Zone Classification
Type Const.
West
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
6. ADDRESS
ZIP
DWL Area I Basement Area
CHANGE OF USE FROM
6.
IT
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N. ❑ RPL. ❑ MVE.
MECH: 0 M.H. 0 POOL
❑ OTHER
Building Area in Sq. Ft.
Garage Area
Split Entry Split Level
No. Baths I No. Floors
CERTIFICATE
of EXEMPTION
No. Rooms
Storage
Rancher
Rec. Room
Req'd. Rec'd. (Not Req'd.
8.
DESCRIBE WORK
9.
VALUATION
Source
of
Utilities
GAS ELECTRIC I WATER SEWER
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of Eonstruction.
DATE
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or local law regulating construction or the
SIGNATURE_
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE( 01 OFFIC
APPR! 0R ISSUANCE
•
FEES COLLECTED
Single $
Building
Plumbing
Mech. t --"
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$L_3. V
PERMIT NUMBER
79— 4`a3
DATE • �� /*11/300979
,ill*
*1300
*13.006
A *000
422
07-12-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07 -i2 -i9
42,M *1330°,-_,
INSPECTOR