1980, 08-21 Permit: 80-8917 Heat PumpPLAN NUMBER
(vi
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
JOB ADDRESS
1. sQ'''° t ��JSI4/ ii4N AAicA r'ioil•L7
LOT LO K UB SION
2.
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
3. 10A-ut- Sc o TT
4.
PHONE
��p117
PARCEL NUMBER/S
ADDRESS
CONTRACTOR
71 0 S C O ,H i+Tsiv 6-&
ADDRESS
5.
'g5'oa1 C TRF/v
DESIGNER
ZIP
PHONE
$.j5-4117b—
ZIP
f 73-o G
PHONE
Actual Set Backs in Feet
North 'South [East 'West
Size of Parcel I Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes ❑No l] Req'd.
Valuation Building Area In Sq. Ft.
ADDRESS
ZIP .
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE 0 NEW
7. OF
WORK 0 BLD.
❑ ALT. 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. I7(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.
D SCRIBE WORK
$ ALUATION SOURCE
OF
9. UTILITIES
80., Da
Enum. Dist.
Location (Area)
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
Iii/
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
utilities
Plans Examiner
SEPA Checklist
Building Technician
SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED ,
Single $
Building
Plumbing
Mech. •
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
-.vim
Y
PERMIT NUMBER
ao i7
'04* *9.00
*9.00 N
*9.006
E *Q00,8
.89t62
08=21-80
6472
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
�IB;,r2 ie::8 01
DATE ISSUED
891Tz
PERMIT NO.
.*9.002 -
TOTAL