HomeMy WebLinkAbout1980, 04-07 Permit: 80-3164 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
LOT
BLOCK
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
SUBDIVISION
3.
OWNER
. \<-LA
ADDRESS
h. ( V L �o
CONTRACTOR
4. ADDRESS —
J
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
HON
ZIP
C 30
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
D NEW
O BLD.
O ALT.
❑ PLMB.
RHONE
Ll)>-Ss—�;>
ZIP
PHONE
ZIP
TO
AD N. 0 RPL.
E,MECH: 0 M.H.
❑ MVE.
O POOL
0 OTHER
Required Set Backs in Feet
North 'South East
Size of Parcel
Type Const.
Occupancy
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area
Split Entry
No. Baths
Split Level
Storage
No. Floors No. Rooms
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. =�-
�6�
VALUATION
9.
`Source GAS ELECT I WATER
of v
Utilities x xx
SEWER
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. I '
DATE I'—, ' IP) SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health`
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
//7`8o OFFICIAL prA
APPROVED FO UANCE
FEES COLLECTED
Single $
Building
Plumbing
C,
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
M
PERMIT NUMBER
BO -31 cel
DATE '(— `t ").
u4* *900
*9.00 5
*9.006
E *0.00
31632
04-07-80
61479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
°a:41 -13.17'4o
316,4c *9,00a�
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