1983, 08-15 Permit: 83A-7802 Heat PumpIPLANNUMBER I APPLICATION /PERMIT �G� PERMIT NUMBER f
Il SPOKANE COUNTY — DEPARTME"qAr OF BUILDING & SAFETY 53 5 cl?;7�50
cm NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1.,�/
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNERPHONE
/ "-.. X1
PHONE
Gi�C- /L t�_
3•
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
-:ham
North South East
West
CO AFyT i
L ENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
4 • d �✓
n
Commercial ❑
AD RESS
ZIP
Type Const.
Occupancy
Spr❑Norte
l s ��
1j„Z0i '
❑Yes ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
-
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
TO—
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TOF YPE ❑NEW 11 ALT. 11 AD'N. 1:1 RPL. El MVE.
%• ❑OTHER
WORK ❑BLD. ❑ PLMB. ❑ MECH. ❑ M.H. 11 POOL
Exempt.
Required
Yes❑ No❑
Number
orCart
or Variance
Received
YesD No n
DESCRIBE WORK/
Shorelines/Flood Hazard
Plans Required El8rt
l i L�c't i c--
Yes❑ Not Applic. ❑
Received ❑
VALUATION
9•
SOURCE
GAS
ELECTRIC
PUBLIC O
SSEWAGE
EPTIC ❑
I
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
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 au-
Building
thority 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
Plumbing
SIGNATURE OF /' , APPLICATION _
' /� p %lam ���
OWNER OR AGEN (� 1/!'�/� DATE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Beck ins �� IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
eG
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
;
08 +15-83 780.22
DATE ISSUED PERMIT NO.
*�4.00°�
TOTAL
Y
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O
Ca
W
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