1980, 06-26 Permit: 80-6354 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
3
JOB ADDRESS
LOT BLO K
OWNER i}7/
) % )
SUBDIVISION
4.
P ON
ZIP
PHONE
ADDRESS' f'
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZI P
TO
TYPE 0 NEW 0 ALT. AD'N. ❑ RPL.
7. OF
❑ BLD. 0 PLMB. 'MECH. 0 M.H.
WORK �
DESCRIBE
WORK, J1
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
❑ MVE.
0 POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Size of Parcel
Type Const.
Occupancy
Valuation
Main Floor
Area of Decks
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
Storage
Unfin. Basement
ELECTRIC
WATER
SEWER
No. Baths
No. Stories No. Rooms No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Req'd. Rec'd. Not Req'd.
Location (Area)
Ownersh i p
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 INSPECT)OfJS
DATE OF APPLICATION s C
SIGNATURE APPLICANT Z 2r '` J :Jr
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
FOR GAS APPLIANCES
PIPE SIZES
PIPE LENGTHS
BTUS
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Z vti'
Mech.
Lam.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
Lc~
M
PERMIT NUMBER
04* *9.00
*9,00 (A
*9.006
B
*000 Ov
63538
06-26-80
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
D4e64e6Fii —8 0
PERMIT &J< , A z *' 9 n n o.4