1983, 01-17 Permit: 83A-391 Heat PumpsL-
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
LOT
2.
BLOCK
SUBDIVISION
OWNER
3 L)J!
ADDF}ES 7/ IA
CONTACTOR
4. ADDRDS
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
p- if
DESIGNER
FJ. ADDRESS
ZIP
%(i)-NiE P,LSL
PHONE
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel I Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor ` Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW ❑ ALT. j ❑,/AD'N. ❑ RPL.
❑ PLMB. lX MECH. ❑ M.H.
❑ BLD.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WQRK
8. cjx.
VALUATION
9.
SO4•CE
6F
UT ITIES
(4?-10i
f
GAS
ELECTRIC
?9(
WER
CERTI FICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
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
SPECIAL MPPROVALS
'JAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BOng T, nician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
LL A-r
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
t2 �.
TOTAL $ ! .-0.
PERMIT NUMBER
S -sA - "3a
04* * 1 9,00
*19.006
A *0.00
39.0
01--17-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0;!1'-''3.7
39.12 *19,OOa�
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL