1981, 08-21 Permit: 81A-8401 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WT.SFiINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3•COPIES
JOB ADDRESS
LOT BOCK SUBDIVISION 6—��-4—
2.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
3.
OWNFji
ADDRESS 0i&4
CONTRACT n /
4.
ADDR£S$ rJ (li 5-/ E -r gw r
PHONE
.7-1 V-- P45'6 Y
ZIP
Actual Set Backs in Feet
North (South East (West
5.
DESIGNER
PHONE
S3 r YP7r
Size of Parcel I Zone Classification
ZIP -_ /.394"
97.go‘-
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unf in. Basement
❑ NEW
❑ BLD.
❑ ALT. 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. AMECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DE RIBE WORK //1 _/ L
B. J Q// W R
VA U TION_I(S•OURGE GAS ELECTRIC
191
OF
9. UTILITIES
Enum. Dist.
Location (Area)
SEWER,
Ownership
Public ❑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//�'�'�
DATE OF APPLICATION / 2 D � .P',J SIGNATURE OF APPLICANTc tom/ ����L-(�,�,G1
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu Ing Technician
'J -'r
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing a J
/v -
Mech.
151
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
PERMIT NUMBER
S UA -840
04* *14.00
* 14.00 tn
* 14.006p
*0.008
A *
OO
840:02
08-21-81
2 6479.
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
111181 12F1"8 '1'
8'410 1
11.4.00 0
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL