1980, 02-07 Permit: 80-983 Heat PumpPLAN NyMBER
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
1.
2.
JOB ADDRESS
Re, 01776atc_'
LOT BLOCK 5 BOIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER
3 1c+,i/i.0 /t4T7? kc y
ADDRESS
PHONE
ZIP
Required Set Backs in Feet
North 'South [East 'West
4.
CON ACTOR •
n4 -1y Neat/
� 3bc�3 L,e e.5� ,?
PHONE
4184 --17141--1714177
Size of Parcel - 1 Zone Classification
ADDRESS n-
[
Z49.2_07
Type Const.
O ccupancY
Sprinklered
Oyes ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE 0 NEW 0 ALT. I AD N. 0 RPL. 0 MVE.
7. OF
WORK 0 BLD. - 0 41_M B. 1p MECH: 0 M.H. 0 POOL
DESCRIBE WORK
m1t// / VI rk heci in,
8.
VALUATION
9.
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
Source
of
Utilities
GAS
ECTRI
WATER
SEWER
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 state or local law regulating construction or the
performance of construction.
DATE ea --- - g 6 SIGNATU -_e4ua
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
.Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
0271 c n 47
I# JwdL
caazuc� u�
2-7- $v
DATE OFFICIA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mechono()
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
f9 as
PERMIT NUMBER
g0 -9P-3
DATE v> —10
04* *9.00
*9.00 N
*9,0.06
B *000
9822
02=07'-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0 2;4.'017!•: '0l 9 8, 3.5 * 9, 0.0 F.