1980, 05-07 Permit: 80-4400 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARP TO MAKE 4 COPIES
1.
2.
3.
JOB ADDRESS
o
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
CON�T�R�A'C/TOORRR
4. RESS
57 IJf)At - "
DESIGNER
5. ADDRESS
PHONE
9�y'/7x5'
Z I I^-� 2a• /.
P ONE
.3 17-z 7s
PARCEL NUMBER/S
Required Set Backs in. Feet
North 'South East 'West
Size of Parcel - Zone Classification
920-
Type Const.
Occupancy
Sprinklered
Des ❑No 0 Req'd.
'PHONE
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area ( Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW 0 ALT. 0 RPL. ❑ MVE.
❑ BLD. ❑ PLMB. 0 MECH: 0 M.H. ❑POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESC R
8.
ALUATION
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
9.
1 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.
DATE SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
Env. Health "
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS: -
FOR GAS:.
PIPE SIZES:"
PIPE LENGTHS:
BTU'S:
DATE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
eye
$
3±,0_
PERMIT NUMBER
M -D-,ROD
DATE
04*
E
439.98
05,:07`,-80
g 6479: -
WHEN MACHINE VALIDATED IN THIS SPACE,
,THIS BECOMES.A PERMIT.
;;8.O, 4''4"0 0
OFFICIAL
*9.00
*9.00 17)
*9.006 •
*Q00 8
n; Da J
APPROVED FOR ISSUANCE