1982, 07-07 Permit: 82A-5805 Heat PumpPLAN NUMBER
APPLICATION /PERMIT 10571
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
4.
JOB ADDRESS
E. 9712 Archery
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER /S
OWNER
MR. AND MRS. JIM DE ROETTH
ADDRESS
E. 9712 Archery, Spokane, Wa.
CONTRACTOR
Sturm Heating, Inc.
PHONE
926 -8223
ZIP
99206
Actual Set Backs in Feet
North !South [East (West
PHONE
325 -4505
Size of Parcel 1 Zone Classification
ADDRESS
E. 204 Indiana
ZIP
99207
Type Const.
Occupancy
Sprinklered
❑Yes ❑No El Req'd.
5.
DESIGNER
PHONE
Valuation )Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8. INSTALL HEAT PUMP
VALUATION
9.
SOURCE
OF
U TILITIES
SYSTEM.
CERTIFICATE
of EXEMPTION
Enum, Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
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 INSPECTION S
DATE OF APPLICATION 7 -2-82 SIGNATURE OF APPLICANT
AY
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
4.50
1n on
PERMIT NUMBER
04* *1400
*14.006
A *0,00 S
580,42
07 -08-82
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0.7 - 0 7-42
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PER5OrN5.z
*14 0 0 �A L