1982, 07-09 Permit: 82A-5838 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 3 COPIES
JOB ADDRESS
Archery
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER /S
OWNER
3 Carl Jacobson
P 9228 6581
ADDRESS
E. 6906 Archery
2199206
4' ADDRESS
E. 204 Indiana
CONTRACTOR
Sturm Heating, Inc.
PHONE
325 -4505
2199207
DESIGNER
PHONE
ADDRESS
ZIP
Actual Set Backs in Feet
North 'South East West
Size of Parcel Zone Classification
Type Const.
Valuation
Main Floor
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
,y❑, AD'N.
l�l MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
Install Heat Pump
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
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
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 7 -7 -82 SIGNATURE OF APPLICANT
1
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
4.50
Mech. $10.00
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ $14.00
/11
04*
PERMIT NUMBER
� —
A
5755
07 -07 -82
6479
*14.00
*14.00
*0.00
n
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07- 09 -82 58/85 *14002g -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL