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1980, 02-01 Permit: 80-1060 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 4 COPIES JOB ADDRESS 1. LO a LOT BLfSUBd DIV S ON CONTRA TOR 4. A . aoc DESIGNER 5. ADDRESS P v? —4.43 ZIP LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S Required Set Backs in Feet North 'South East (West .[^ (2J5—S-ize of Parcel Zone Classification PHONE PHONE Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. 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 8. 9. ❑ NEW ❑ BLD. DESCRIBE WO VALUATION O ALT. O PLMB. AD'N. MECH: Source of Utilities A` ❑ RPL. ❑ M.H. GAS ❑ MVE. ❑ POOL 0 OTHER ELE TRIC No. Baths No. Floors No. Rooms Rec. Room WATER CERTIFICATE of EXEMPTION SEWER Req'd. 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 tte or local law regulating construction or the performance of construction. DATE C) — VJ `0 SIGNATURE 5!f'ruL f?t DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAK CONDITIONS: DATE,1,--5 ,FiciAL Rec'd. Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. Plan Check (.Q SEPA Mobile Home Other (Specify) TOTAL $ ,D0 i' DATE (V. - S?d PERMIT NUMBER .=6p 10toD 04* * 9,00 * 9.00 * 9,006 E *0,00 105,9 02-11-80 679. CO WHEN MACHINE VALIDATED IN THIS SPACE, THIS ,13 SOrjESA.BEBMIT.j Un *9.0r!aH INCDFrrrR