1981, 06-17 Permit: 81A-6029 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
3.
APPLICANT: CO LETE NUMBERED SPACES - PRESS HARD TO MAKE 3_COPIES
JOB ADDRE$s / anti, LEGAL DESCRIPTION - SEE ATTACHED 'l T Cl PARCEL NUMBER/S
LOT
BLOCK
OWNER—1
BD VISION
2 A .
P4Drl -i%s
ADDRESS -7 V3 r
S. 3 �P I 5 1nKA0 1,
ZIP
Actual Set Backs in Feet
North 'South
East
West
4.
CONTRACTOR
CFW-
PHONE
ZIP
Size of Parcel - 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ENo E Req'd.
5.
DESIGNER
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfln. Basement
O NEW 0 ALT. ....)SAD N. 0 RPL. 0 MVE.
❑ BLD. E PLMB. „KMECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No; Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRI E WORK
6. ozpL a c9 ar yr��121._J
VALUATI N
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
y� x
Enum. Dist.
Location' (Area)
WATER I' SEWER
Ownership
Public 0 Private 0
USE CODE
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 /��/�)p�jjj'
DATE OF APPLICATION SIGNATURE OF APPLICANT \ �.' Lt 7�+'�S 1.1
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
anning y
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building TeChniclan
e ern
1
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
• FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
O
TOTAL $ I
PERMIT NUMBER
St A- -CoCiati
04* *1400
* 14.00 Lip
* 14.006
A *000 8
6o 28A
0.6-17-8.1
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0161i1171iii'18 6 0 2 9
Z 1:4.00 -
DATE ISSUED PERMIT NO. TOTAL
›-
0-
-J C_J
LL