1980, 04-04 Permit: 80-3095 Heat PumpPL_AN 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 4 COPIES
JOB ADDRESS
LOT
2.
BLOCKFL
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
3 !_�fI C HIac Et OTTQM
AD ESS
F' o. fx:c 1it:74. /
CONTRACTOR
4. /4A-1 HEATIIVa LI AiPi6onrp.
ADDRESS
E_ /111,5- 't 1 LC
DESIGNER
5' ADDRESS
PHONE
ZIP
9'C) )/
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
[East
(West
PHONE
l /Jc • -9156/
ZIP
9 2 CT
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
=Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area Basement Area
Garage Area Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. U l - clly
VALT N
g.
?. i-G►J HE/11 Pi,aMP
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
3n 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
)erformance of construction.
'1,TE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
'fanning
e Marshall
engineer
ies
Clearance
a Checklist
SPECIAL CONDITIONS:
e
DATE/"'1-4-M OFFICIA44--
L t IVVYVCTY\
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ et)
PERMIT NUMBER
DATE
04* *900
*9,00 tri
*9,006
E *0.00
309,42
04-04-80
6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES,A, PERMIT.
4—D n: "
309,55 *9DOaF2
1