1979, 08-14 Permit 79-2110 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 DDRESS
LO
BLOCK
OWNER J)
3.
4.
ADDRESS
J VtS t fV I3 I ()IN
w- 7/7
CONACTOR
ADDRESS
930
DESIGNER
PHONE
-ycrs-/a
47920/
PHONE
.5"j '-c -q'7
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
NEW
❑ BLD.
ZIP
q9 ZD2
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North
South
Size of Parcel
Type Const.
Occupancy
East
Zone
West
Classification
Sprinklered
❑Yes ❑No D Req'd.
Valuation Building Area in Sq. Ft.
TO
❑ ALT. ❑ AD N. 0 RPL. ❑ MVE.
0 PLMB. MECH: ❑ M.H. 0 POOL
0 OTHER
Split Entry
No. Baths
Basement Area
Garage Area
Split Level
No. Floors No. Rooms
Storage
CERTIFICATE
of EXEMPTION
Req'd.
Rancher
Rec. Room
Rec'd.
Not Req'd.
DESCRIBE VjORK
/
ION
.12.nt±
VALUA
9.
Sourc�
of
Utilities
GAS
ELECTRIC
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
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
eetc.„6, C Y2-0(J)-
Ige.,,
771-aikbe-)
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
.00
Or_ (Specifyl 3 .O
TOTAL $ -i
PERMIT NUMBER
-79-�-l►.��
DATE
0 C!.
A
21Q9R
08-14-79
2 6479.
*9.00
*9.00
*9.006
*Q00 8
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-114-79 2110 *9.00
APPRR ISSUANCE —