1981, 09-14 Permit: 81A-9277 Heat PumpGAS
D SCRIBE WORK 1� -
- 3 (eG�—Cie a/ /(/
VALUATION
IPLAN 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. 'Di, 7 /ooPa�
LOT BLOCK SUBOI IS ON
2.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OW l# R
3.
PHONE
9-;-T-,t,,
ADDRESS
7,0 Ac_
ZIP
9 9-'i,
Actual Set Backs in Feet
North 'South
East
'West
TRACTOR
4. J. >ADD
PHONE
.-?--17417-
Size of Parcel
Zone Classification
ZIP
99 two
Type Const.
Occupancy
Sprinklered
❑Yes DNo 0 Req'd.
5.
DESIGNER
PHONE
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
Unfin. Basement
7.
TYPE
OF
WORK
O NEW 0 ALT. piAD'N. 0 RPL.
O BLD. 0 PLMB. 0 MECH. 0 M.H.
❑ MVE.
❑ OTHER
0 POOL
No. Baths
NO. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
SOURCE
OF
UTILITIES
Enum. Dist.
T
Location (Area)
LECTRIC WATER
SEWER
Ownership
Public D Private 0
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
VDATE OF APPLICATION 9 —// — e/ SIGNATURE OF APPLICA • ai p K r+e
SPECIAL .JPPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer.
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $%%
PERMIT NUMBER
QIk 9277
04* *14,00
* 14,00
* 1/4.006
A *000 OU
927.62
09-14-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
kOt '0i.91 111!4! 'Bll; 9'2X7,7 Z
'DATE ISSUED: PERMIT NO.
440b o.k
TOTAL