1980, 07-01 Permit: 80-6573 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
JOB ADDRESS
1. ,*'24//y S./C.-a ,r%' 71
SUBDIVIS ON
2.
3.
LOT
OWNER
ADDRESS
BLOCK
LEGAL DESCRIPTION '= SEE ATTACHED
7e, , ret
PHONE
PARCEL NUMBER/S
CONTRACTOR
a. , er c Yee{
ADDRES5 733ZY AZ'
DESIGNER ' .
5.
ZIP
99.207
PHONE
3zlsIDB
Actual Set Backs in Feet
North (South East 'West
Size of Parcel Zone Classification .
PHONE
Type Const.
Valuation
Occupancy Sprinklered
Elves DNo 0 Reg'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE ($'NEW
7. OF
WORK 0 BLD.
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ ALT. -D AD N. 0 RPL. 0 MVE.
❑ PLMB. RI MECH. 0 M.H. D POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Reg'd.
Rec'd.
Not Reg'd.
DESCRIBE WORK
8. diecoeil .5 4e./rae - ..- e e
� eft,-
9.
VALUATION
URGE GAS
OF
UTILITIES
WATER
SEWER
Enum. Dist.
Location (Area)
Ownership
Public ❑ Private 0
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provision's 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 2r
n//
SIGNATURE OF APPLICANT-ar�
SPECIAL APPROVALS
NAME DATE
Env. Health
fanning
Fire Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B in echniclan
ZWC
SPECIAL CONDITIONS: .
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single
00
Building
Plumbing
cao'
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
goo
M
PERMIT NUMBER
806,573
04*. *9.00
*9.00 N
*9.006
B *0._00 S
6572207-0,1-80
6479.
WHEN MACHINE VALIDATED IN .THIS SPACE,
THIS BECOMES A PERMIT.
Ig 0l
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
65'1-35 *9.0'0,a.� -
o_
O
O
UJ
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