1982, 02-08 Permit: 83A-913 Heat PumpsNvUMBER
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
BLOCK
BDI ISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
OWNEF
3. jV�LJ( 3 `
PHONE
ADD 7/ 7
CO N T C/T} OPj, (j
4' ADD SS
ONE
P O,��'-fo2.s�
Actual Set Backs in Feet
North 'South
East
Zon
West
Size of Parcel a Classification
Type Const.
Occupancy
DESIGNER
5.
ADDRESS
PHONE
Valuation
ZIP
CHANGE OF USE FROM
6.
TO
Main Floor I Upper Floors
Area of Decks
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basemen
Unfin. Basement
TYPE NEW
7. OF
WORK El BLD.
❑ ALT. ❑r AD'N.
❑ PLMB. py 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.
DESCRIBF1 WORK
8. f 1 7
VALUATION
9.
SOU RC
OF
UTILITI.S
GAS
ELECTRIATER
Enum. Dist. I Location (Area)
SEWER
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that 1 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 > iP 3 SIGNATURE OF APPLICANT 6•-k
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buil
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 $
PEr:M:T iN:JMBER
Pqk 213
04* * 1 9.00
* 1 9.00'6
A *0,00
7 IL.
02 -08-82
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01 -0 8 -8 2 9'L3'z *1'9.0 0 T. -
DATE ISSUED PERMIT NO. TOTAL