1980, 09-05 Permit: 80-9711 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
JOB ADDRESS
1. s 3 x /t
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNR
3. Ai 1/ 477t X -
PHONE
9.42 `lG' 77 C7
ADDRESS
5. 3a/O ,& 1-4- AY
CONTRACTOR
4 ( Q�t,> / f f/r��
4' ADDRESS
E v -
/d• 7/ /--
DESIGNER
5. ADDRESS
ZI P
9'9vZ o 6
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
9 NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
L1'471 co/act
ZIP
PHONE
ZIP
TO
O AD'N.
O MECH.
❑ RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
Actual Set Backs in Feet
North 'South 'East West
Size of Parcel
Type Const.
1 Occupancy
Valuation
Main Floor
Upper Floors
Area of Decks
Zone Classification
Sprinklered
❑Yes DNo 0 Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
Storage
Unfln. Basement
DESCRIBE WORK
8. A ,/C-/
VALUATION SOURCE QdAS
OF
9. UTILITIES
/7;
e A r S /`iti t 1 411,0
ELECTRIC
WATER
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
SEWER
No. Rooms
No. of Dwellings
Req'd.
Location (Area)
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
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAf4 DATE
Env. Health
w
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ °L.
PERMIT NUMBER
8a- 97//
04* *9,00
* 9.00
* 9.006
E - *Q00 S
9703
09-05-80
B 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
096+05'-81
DATE ISSUED
9'71,1 z
PERMIT NO.
*"9,00CCI.
f
TOTAL