1982, 08-04 Permit: 82A-6772 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
2.
JOB ADDRES
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LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
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ADQB ES
$
DESIGNER
5. ADDRESS
PHONE
PARCEL NUMBER/S
ZIP
1OE-o f�
P ONE
Zi°
PHONE
`�t!'
Actual Set Backs In Feet
North (South
East
'West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
Yes ❑No ❑ Req'd.
Valuation I Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area'
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
ALT.
0 PLMB.
WAD N.
0 RPL.
ECH. I] M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
' CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
D SC BE WORK
B Mk—
VALUKTION
9.
SOURCE
OF
UTILITI
1610 2
GAS
ELECT IC
Enum. Dist.
Location (Area)
WATHR
SEWER
Ownership
Public 0 Private 0
USE CODE ,,
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
OP—
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall ,
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Solidi Tec an rr
SPECIAL CONDITIONS:
v
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
/Sit-_
PERMIT NUMBER
04* *14.00
*14006
A :*0.00
677.1
08-04-E •
B 6479.K y
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12 677;22
*1400'°x.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
3—
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