1980, 03-20 Permit: M-80-2423 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 911 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. k /o�,r #v7F.0 £4
LOT BL CK UBD 1 ION
2.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNER
a /Lt.& k A r Yl/1 / /R t�A
DDRESS
5 Q -,n ca.. --
C
awC• NTRACTOR
5.
/DRESS 16, n9'
PHONE
9,16 -Y3a y
Zg 9:td,6
Required Set Backs In Feet II
North 'South 1East 'West
DESIGNER
?A PHONE
v173-
Zj9;z0 6
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑yes ONo 0 Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
7.
TYPE
OF
WORK
0 NEW 0 ALT. %AD N.0 RPL. 0 MVE.
0 BLD. 0 PLMB. 0 MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE ORK
8.
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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.
DATE SIGNATURE - -
SPECIAL APPROVALS
DEPT. • REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DAT Et R0 /1 JO FFI CI AL ) l4C ` l exervv'1/41S A. -
APPROVED FOR ISSUANCE
FEES COLLECTED
•
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL '
DATE
PERMIT NUMBER
PA -%0-a1423
.04*
*,9.,CJ 0.
*'9.00.
*9.006
E' *Q00
2422.`R
103:=210=80
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
013J-2'',=180' 24235 *9.00.2p
A
ECO .:e -S 1l��ee .. {�{�i:' o l) rr��n�C��jj�]]o — q
SEP
DATE . REMARKS
Final Inspection.
INSPECTED BY
0o-cn-on
E .GCC
COY,'
*6 0 N
05.4 *6130