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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