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1980, 05-06 Permit: 80-4372 Heat PumpPLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 JOB ADDRESS LOT APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES S ca/5 /2-O BLOCK SUBDIVISION 3 OWNER ADORE A e n kavcd CONACk�✓^�\ Lei 4' ADDUSS DES GNER ADDRESS LEGAL DESCRIPTION - SEE ATTACHED PHONE ZI P PHONE PARCEL NUMBER/S Required Set Backs in Feet North 'South East (West Size of Parcel Zone Classification z f,0/ Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. CHANGE OF USE FROM 6. TO PHONE ZI P Valuation Building Area in Sq. Ft. DWL Area I Basement Area Split Entry Garage Area Split Level TYPE 7. OF WORK 9. ❑ NEW ❑ BLD. DESCRIB�ORK VALUATION ❑ ALT. ❑ PLMB. ❑ AD'N. ❑ MECH: ❑ RPL. ❑ M.H. ❑ MVE. O POOL 0 OTHER No. Baths No. Floors No. Rooms CERTIFICATE of EXEMPTION Req'd. Source of Utilities GAS ELECTRIC WATER SEWER 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 th performance of copstruction. DATE DEPT. SPECIAL APPROVALS REQ'D. REC'D. SIGNATURE Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: • DATE OFFICIAL '/{�(it�C[/.�l/LI//LGA/ `"r APPROVED FOR ISSUANCE Storage Rancher Rec. Room Rec'd. Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) 1(31 TOTAL $ / PERMIT NUMBER DATE S-� —(?2: *900 *900 *9.006 B *Q00 437.1R 05-06-80 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMESA PERMIT. 05'`06-80 437.22 *9.00°'