1982, 03-22 Permit: M82A-2021 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 `�— i //
1. J tf15�j//_Lp
LOT L
LEGAL DESCRIPTION — SEE ATTACHED
2.
OCK
SUBDIVISION
3.
4.
5.
OWN/ R I/r/lAC-gi_ J /, /CT/z.de d
ADD; S 3-7 "7 e- .,C�P�di
CON�tACTOR
p/25 sic?
6NE% 1i
PHONE.
•
PARCEL NUMBER/S
Actual Set Backs In Feet II
North (South (East 'West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfln. Basement
TYPE 0 NEW0 0 ALT. ❑ A N.
7. OF
WORK BLD. 0 PLMB. MECH.
8DESCRIBE WW RR
- VALUATION SOURCE
OF
9. UTILITIES
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
GAS 1 ELECTRIC
WATER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
Req'd.
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 localw regulating enstruction or the
performance of construction SEE REVERSE SIDE FOR REQUIRED INSPECT .NS
DATE OF APPLICATION.
02
SIGNATURE OF APPLI
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT 1S NONTRANSFERABLE
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing - /
Mech. / L/C&
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
✓U
PERMIT NUMBER
62, -7-021
04* *14,00
* 1400 175
* 14.006
A *000
20208
0322-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
;.l t' 1 I
043:.; 2 2'-;8)21 •
2.0211 *.1400. i -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL