1980, 01-02 Permit: M-80-A-9713 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 4 COPIES
JOB ADDRESS
/-7- _.,_ - 0— -j I LEGAL DESCRIPTION - SEE ATTACHED
1.
(' W .S
orth South
LOT
BLOCK
Zone Classification
2.
hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
I
JSUBDIVI�
Sprinklered
OWNER,/ M
' X+
3.
�i l /�►' ..
aluation
ADDRESS n
i7tl�
DATE' Oy 00SIGNATUR n"`�" "` Mech.5(�
CONTRACTO
4.
Basement Area
I Garage Area
ADORES
Env. Health
SEPA
DESIGNER
'' ADDRESS
CHANGE OF USE FROM
6.
ZIP
PHONE
PHONE
ZIP
TYPE ' ❑ NEW ❑ ALT. D"AD'N. ❑ RPL.. ❑ MVE.
7 OTHER
WORK ❑ BLD. ❑ PLMB. jJ�MECH: ❑ M.H. ElPOOL ❑
DESCRIBE W K
8. I
equired Set Backs in Feet
Source
of
Utilities
orth South
East West
ize of Parcel
Zone Classification
hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
Type Const.
Occupancy
Sprinklered
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
Dyes ❑No ❑ Req'd.
aluation
Building Area in Sq. Ft.
DATE' Oy 00SIGNATUR n"`�" "` Mech.5(�
DWL Area
Basement Area
I Garage Area
Storage,
Env. Health
SEPA
Split Entry
Split Level
Rancher
` Mobile Home
Fire Marshall
No. Bath7
No. Floors
No. Rooms
Rec. Roorr
TOTAL $
Zone Clearance
CERTIFICATE
Req'd.
I Recd.
Not Re
of EXEMPTION
• DATE OFFICIAL
FEES COLLECTED
PERMIT NUMBER
/�j
l PO —A— r1 /-
DATE
04* *9.00
*9,0.0 N
*90.06
E *00.0
971,2;
01-02,-8,0
@ 6479.
VALUATION
9,
Source
of
Utilities
GAS
ECTRIC
i
WATER
SEWER
Single $
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 Building
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. Plumbing )
Q
DATE' Oy 00SIGNATUR n"`�" "` Mech.5(�
SPECIAL APPROVALS SPEC I L ONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning Al
i,
` Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
IN
WHEN MACHINE VALIDATED
SEPA Checklist THIS BECOMES A�PPERMIT.
1
0 Il �r 0' 2• '•��o`
• DATE OFFICIAL
APPROVED FOR ISSUANCE
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