1980, 09-17 Permit: 80B-0361 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 ADDRESS
LOT
BL•CK
3
pg
SUBDIVISION
OWNER
✓d%�� //4
PHONE
r7C 2 '(/
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
ZIP
P9ZO 7
4.
CONTRACTOR
/e,'- Tamed l'( , /e
PHONE
3
ADDRESS
//'/10y
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TO
ZIP
1
PHONE
ZIP
Actual Set Backs in Feet
North South East (West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
Main Floor
Upper Floors Garage Area
Storage
TYPE
7. OF
WORK
' "NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL
❑ OTHER
9.
DESCRIBE WORK
VALUATION SOURCE GAS
OF
UTILITI ES
/ ✓� /I'i-/✓
ELE RIC
WATER
SEWER
Area of Decks
No. Baths
Finished Basement
Unfin. Basement
No. Stories
CERTIFICATE
of EXEMPTION
No. Rooms
No. of Dwellings
Enum. Dist. Location (Area)
Ownership
Public 0 Private 0
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 9 //'-0 SIGNATURE OF APPLICANT Jam•em
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
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)
r
TOTAL $�
PERMIT NUMBER
? 3 —36/
04* *9.00
*9.00 N
*9,006
A *0,00 8
3600
09-17-80
g 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
o+ A71 l.SAT '3 6. ]A
DATE ISSUED PERMIT NO.
*-9A02:�
TOTAL