1980, 05-05 Permit: 80-4283 Heat Pump,[L7 N-,IUMBER 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 r
ra0oo LEGAL DESCRIPTION -SEE ATTACHED
OWNER
3.
ADDRESS(
CONTRAC-
4. ADDRESS
DESIGNER
5. ADDRESS
n
PHONE
ZIPActual
Set Backs in Feet
North South East West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes []No ❑ Req'd.
PHONE
Valuation
I Building Area in Sq. Ft.
ZIP I Main Floor I Upper Floors I Garage Area I Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin, Basement
6.
TYPE�❑ ❑ ❑ No. Baths No. Stories No. Rooms No. of Dwellings I NEW ❑ ALT. AD'N. RPL. MVE.
7, OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑BLD. ❑ PLMB. �I MECH. ❑ M.H. ❑POOL
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
8 Al 1-3c 11 -iA� r, -4— ` nn i r-1
FEES COLLECTED
VALUATION I SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑Private ❑
Single $
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 Building
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 Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT I Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env, Health
SEPA
Planning
Fire Marshall
Mobile Home
Other (Specify)
Co. Engineer
�_
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDAI
SEPA Checklist
THIS BECOMES A PERMIT.
PERMIT NUMBER
04* *9.00
*9,00
*9,00U
E *0:00
42R2�
05-05-80
6479.
IN THIS SPACE,
iician PERMIT IS NONTRANSFERABLE O i Q 5- 8 0 4 2 8, 3 '05 * 9, 0 0 LL F-