1980, 12-19 Permit: 80B-5086 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
1.
2.
3
JOB ADDRESS
5. /7,26 34.0\14.1,5
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
i7 / (rte /A) &) '7 7 4'l
/DRESS
Cc's✓VJ7 ! .
C
PHONE
9y -/s-&3
PARCEL NUMBER/S
O. L3o, /,1'7'71/
ZIPq
110 (<s
Actual Set Backs in Feet
North 'South [East (West
CONTRACTOR /
4. �O DNS W1 7'6- � e
ADDRESSS-7/
ij
e' 7 / 6
5.
DESIGNER
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
NEW ❑ ALT. ❑ A 'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. Y MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
DESCRIBE WORK
A/C/i- 'T' fP' U %H P
GAS
9.
VALUATION
SOURCE
OF
UTILITI ES
Enum. Dist.
Duc-7 14)6,C
ILocation (Area)
ELECTRIC
xxX
WAT
SEWER
Ownership
Public ❑ Private 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
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
T9C1l1'ician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
•
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 13..x'
rPE-MIT NUMBER
04* *1300
*1300
*13.006
A *000
50852
12-19-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE 121,'`-..-19 -.Ai
'0
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
50&6'Z *13,0j)ALJ
PERMIT NO.
FII F CnPY