1980, 11-10 Permit: 80B-3486 Heat PumpF -LAN 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
„. z
LOT
OWNER
3
BLOCK
ADDRESS n n
•
SUBDIVISION
4.
CONTRACTOR
ADDRESS
. —SD nom.,
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
M NEW
❑ BLD.
❑ ALT.
❑ PLMB.
OCN E
ZI P
ZIP
fi2 Ego
PHONE
ZIP
TO
❑ AD'N.
2 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
Size of Parcel
Type Const.
East 'West
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
No. Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
x X
WATER
Enum. Dist.
SEWER
Storage
Unfin. Basement
No. Rooms
Req'd.
Location (Area)
Ownership
Public ❑ Private ❑
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 PLICATIO 1 (— � a
SIGNATURE OF APPLICANT (---)ZIVI
'Q)11£.li
11
SPECIAL APPROVALS 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
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
c
Mech. �/
—
Plan Check
SEPA
Mobile Home
Other (Specify)
?pL%
TOTAL $
M
PERMIT NUMBER
Vic, 3+-8P
04*
A
34858
11-10-80
z 6479.
*9.00
*9,00
*9.006
*000
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,11 .18 r'8O
DATE ISSUED PERMIT NO. TOTAL
348,6'1 *9.0022