1980, 05-10 Permit: M80-4620 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.
JOB ADDRESS
E. /4/ 0/-TALI—
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
S B IVISO
PARCEL NUMBER/S
3.
OWNER
ADDRESS
dotV ctip& . U cst_.
n
P ONE
ZIP
Actual Set Backs In Feet
North 'South 1East West
4.
5.
CONTRACTLJN 11
,ADDRESS •J aG' r L (f
DESIGNER
PHONE
Sas-th&
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
DYes DNo 0 Req'd.
Valuation (Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
7.
TYPE
OF
WORK
D NEW
❑ BLD.
D ALT.
❑ PLMB.
(IAD N.
Ai MECH.
D RPL.
❑ M.H.
❑ MVE.
D POOL
0 OTHER
No. Baths
No. Stories
No.- Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK __g.,. 110 ` 1
8. '1 N u
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
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 - y/�/�/�,
DATE OF APPLICATION S `2~ 80 SIGNATURE OF APPLICANT � ' • ti --a"»' rot,
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B ing ni Ian
SPECIAL CONDITIONS:
FOR GAS APPLICATIONS .
PIPE SIZES
PIPE LENGTHS
BTUS
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
�Mech.
Plan Check 1.P`J
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
NV4,a)-1-1 LAO
04v* *9.00
*900 I
.*9.006
E *0.00 S `
4619
05-10'-80
. 61179.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
b5:LiV0.�,8' 4`6..205
*9.0.04,,1 _
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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