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1979, 08-28 Permit M79-2953 Heat PumpPLAN NUMBER /\PLH©/.0 `► [IO P1/I'D{ 1ainld u SPOKANE COUNTY e BUILDING CODES' DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (5091 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 1. JOB ADDRESS LOT BLOCK Aj. / 7/ 7 SUBDIVISION 3. 4. OWNER ADDRESS CONTRACTOR ADDRESS " A"-7.7 «Yl41' , DESIGNER -sas/ ADDRESS CHANGE OF USE FROM TYPE ❑ NEW 7. OF WORK ❑ BLD. ❑ ALT. ❑ PLMB. PHONE 'ZIP PHONE ZIP e PHONE ZIP TO ❑ AD'N. tJ MECH: ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER'S Required Set Backs in Feet North !South East 'West Size of Parcel Type Const. Occupancy Valuation Zone Classification Sprinklered Dyes DNo ❑ Req'd. Building Area in Sq. Ft. DWL Area I Basement Area Garage Area Storage Split Entry No. Baths Split Level Rancher No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Rec'd. Rec'd. Not Req'd. DESCRIBE WORK 8. VALUATION 9. /— Source GAS // of Utilities ELECTRIC XX WATER SEWER 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 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. DATE SIGNATURE DEPT. SPECIAL APPROVALS REC'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: DATE OF CIAL eI //7 '�-- . FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) 9a� TOTAL $ PERMIT NUMBER 79 DATE �(( � 7 / 9%Y 04i* *900 *9,00 *9006 A *A00 8 2952/ 08-28,-79 m 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PE MIT. 08_21 7 29.5,5z *9,000_ A FOR ISSUANCE _