1980, 09-25 Permit: 80B-867 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
3.
ADDRESS
5, )... or
4' ADDRES
JOB ADDRESS 30
LOT
BLOCK
OWNER \ri
SUBDIVISION
CONTRACTOR
C7
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
ZIP
PHONE
ZIP
TO
-KAD N. ❑ RPL.
MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
DESCRIBE WORK
9.
L1
VALUATION SOURCE
OF
UTILIT IES
Q.1.40 IA
GAS ELECTRIC WATER
SEWER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Size of Parcel
Type Const. Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Building Area in Sq. Ft.
Garage Area I Storage
Area of Decks
No. Baths
Finished Basement Unfin. Basement
No. Stories No. Rooms No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum, Dist, Location (Area)
Ownership
Public El Private ❑
Req'd. Rec'd. Not Req'd.
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
6YL—ftY
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildin Tec 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
PERMIT NUMBER
04* *9.00
*9.00 th-
*9,006
A *Q00 8
8668
09 -25 -80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 86.72 'it 9,00
DATE ISSUED
O r
PERMIT NO. TOTAL