1983, 12-27 Permit: 83B-2782 Heat PumpPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT
ERMIT NUMBER
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREETADDRESS
PARCEL NO.
1.
Knox
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
I
OWNER
PHONE
PHONE
Jane Falmo
926-6376
3.
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
E. 8621 I<noX Spok4ne, WA
99206
North South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
S r� UR1'�i H t
111/6/34
325-4505
Commercial ❑
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
E. 264 Indiana
99207
❑Yes ❑No ❑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
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TOF YPE 19 NEW MALT. ❑ AD'N. C1 RPL. 11 MVE.
7. ❑OTHER
Certifi.ofExempt._T
Required Yes[] No❑
Number
WORK ❑ BLD. ❑ PLMBK❑ MECH. E]M.H. ❑ POOL
or Variance
Received Yes❑ No❑
DESCRIBE WORKShorelines/Flood
Hazard
Plans Required El
8• Install Heat UVRIP 20 Amp Service
Yes[] Not Applic. ❑
Received ❑
VALUATION
I SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC 1:1
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9
UTILITIES
XX
PRIVATE El
I SEWER El
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
Building
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating const= e
of construction. SEE REVERSE IDE FOR REOU RED INSPECTIONSPlumbing
4.50
SIGNATURE OF / APPLICAT
4.50
OWNER OR AGENT 1i /, DATE
Mech.
--I
10.00
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular)
MFG. Home
Fire
Prevent.
Fnaineer I
Other (Specify)
Utilities
PlansPERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
19.00 I
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEYS6UEI . 7 — 5 PERM,"Z. 8,2 2'
* 19, i� TOF AL
Y
CL
C
C:
LL
LL