1980, 11-25 Permit: M80B-4192 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
BLOCK SUBDIVISION
U-7 c):��r
LOT
3.
OWNER
ADDRESS
4.
5.
CONTRACTOR
ADDRESS ` n
X30 ci
DESIGNER
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
ZIP
PONE
`j H2 —k 2 ' 2,
PARCEL NUMBER /S
Actual Set Backs in Feet
(South East
North
West
Size of Parcel Zone Classification
ZIP
Type Const.
Occupancy
ADDRESS
CHANGE OF USE FROM
TYPE NEW
7. OF
WORK ❑ BLED_
❑ ALT.
❑ PLMB.
PHONE
ZIP
TO
❑ AD'N.
MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Valuation
Sprinklered
El Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Main Floor
Upper Floors 1 Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
iy"
VALUATION
9.
SOURCE'
OF
UTILITIES
GAS
EL'E/ TRIC WATER
xx
SEWER
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
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 U.``- Z' SIGNATURE OF APPLICANT AkT`bt 4(A„
"
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checklis
ilding
T ++ nician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ (
>M
PERMIT NUMBER
04* *9.00
*900 N
*9.006
*0,00
419,12
11 -25 -80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
1,1; -.-
DATE ISS�IE`ei
419,2 z1
PERMIT NO.
*9.000.
TOTAL