1980, 06-11 Permit: 80-5618 Heat PumpPLAN Nikil B ER
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 /6,5aQ
f.c�
LOT!"" LOCK INDLMD R
2.
OWNER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/5
3. /Aon&smp Co/Sr.
P ONE
Y`7
CONTRACTOR
4. 44—/ Halnn/4��flnPoa/S7. [AIC -
ADDRESS
5.
E.its
DES! NER
PHONE
4/0 —965/
PHONE
Actual Set Backs in Feet
North !South [East 'West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy Sprinklered
Oyes ❑No ❑ Req'd.
Valuation I Building Area in Sq. Ft.
ADDRESS •
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
Tff
YPE yy NEW
7. OF /�
WORK BLD.
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ ALT.
❑ PLMB.
❑ AD N.
Ps MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
'Jot Req'd.
DESCRIBE WORK
8.
INcrRu 4.6 Tort HEATPUnP.11.4aT 1jo K
VALUATION SOURCE GAS ELECTRIC WATER
OF
9. UTILITIES
Enum. Dist.
Location (Area)
SEWER
XX
Ownership
Public 0 Private 0
USE CODE
I hereby certify that 1 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 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall •
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
•
Other (Specify)
TOTAL $ 9.00
PERMIT NUMBER
M40-5
04* *9.00
*9.00 N
*9.006
B *Q,00 B
561.72
06-11-80
_ 2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
bi64P(171:18'0 5'6185 *9,0Oa� -