1980, 12-04 Permit: 80B-4447 Heat PumpAPPLICATION /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 ADDRE 5
LOT
BLOCK
/ 06
SUBDIVISION
3.
OWNER
ADDRESS
CONTRA T•R
P HONIQ.
Z` q
PHONE -
ADD
z
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ZIP
PHONE
ZIP
TO
• NEW ❑ ALT. ❑ AD N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. e9'MECH. ❑ M.H. ❑ POOL
❑ OTHER
DESCRIBE O
•
VALUATION
9.
SOURCE
OF
UTILITIES
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Occupancy
Valuation
Main Floor
CERTIFICATE
of EXEMPTION
Enum. Dist.
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Unfin. Basement
No. Rooms
Location (Area)
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 INSPECTIONS
DATE OF APPLICATION al. go
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ q.eoc)
PERMIT NUMBER
04* *9.00
* 900 N
* 9006
A *0.00
444.6 -2
12 -04 -80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12; -04_80
DATE ISSUED
44472 *9.0,0T e-
-
PERMIT NO.
TOTAL