1980, 11-04 Permit: 80B-3159 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 ADDRES�l J C,
�1, / / / c—--1
LOT
BLOCK
SUBDIVISION
OW ER x
3.
AD KESS
PHONE
ra 1-3 5Y(
ZI27��`�
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South [East (West
4.
TRACTOR
4 c*-
ADDRESS
It '
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE i
`""31 ' 975
Z?�C�
PHONE
ZI P
TO
❑ NEW ❑ ALT. G AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
8. DESCRIBE WORK -/
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Size of Parcel
Type Const.
Valuation
Occupancy
Main Floor
Upper Floors
Area of Decks
No. Baths
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement Unfin. Basement
CERTIFICATE
of EXEMPTION
Location (Area)
Enum. Dist.
No. Rooms
Ownership
Public ❑ Private ❑
Req'd.
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
DATE OF APPLICATION /)"U SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Techn4iA-
SPECIAL
4eZef2Z
CONDITIONS:
�w-
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
FEES COLLECTED
Single $
Building
Plumbing
---
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
re 5 _ A5Y
'04*
* 9.00
* 9.00
* 9.006
A *000
315.82
11-04-80
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'117,04,,'8 31`5c91 *9.00g0- —
DATE ISSUED PERMIT NO. TOTAL