1982, 08-11 Permit: 82A-7059 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 1 (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
JOB ADDRESS
,y1/[�7
LOT BLOCK SUBDIVISION
OWNE Vet
LEGAL DESCRIPTION - SEE ATTACHED
C22
ADDRESS �
PARCEL NUMBER/S
4.
5.
CON CTOR
PkiONE
C72 -2 -
ZIP O2—Z.
ZIP
PHONE
Actual Set Backs in Feet
North (South [East (West
Size of Parcel Zone Classification
ADDRESS
DESIGNER
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation 1 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
Unfin. Basement
7.
TYPE
OF
WORK
❑ NEW
❑ BLD.
D ALT.
D PLMB.
DESC IBE W K
8.
VALUATION SOURCE
OF
9. UTILITIES
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
GAS
ELECTRIC
0 OTHER
SEWE R
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 local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTI S
DATE OF APPLICATION
'-SIGNATURE OF APPLICANT./
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marsha,
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
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 $ /C&'"°°.
PERMIT NUMBER
Olz A -1osq
04* *14.00
*1&00
A *O,CC
705.82
08-1 1 -82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 8ion 't`8°2
705.95
DATE ISSUED PERMIT NC.
*14.00°.�.