1980, 07-21 Permit: 80-7441 Heat Pump, FurnaceAPPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
).
2.
3.
4.
JOB ADDRESS
LOT
lyyo7 MAIr4
SUBDIVISION
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/5
OWNER
D4LE 6Ry4I
ADDRESS
PHONE
gs6-785
E. /4Vc7 M4/u
CONTRACTOR
QAVA/ER FakN,cE 4- ru,EL
ZIP
Required Set Backs in Feet
North (South [East (West
PHONE '
.S1Sr7/I
Size of Parcel - 1 Zone Classification
ADDRESS
W. 122 1,/r/ EA14-
ZIP .
4,102
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation (Building Area I Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area Garage Area
Storage
6.
CHANGE OF USE FROM
.icr
TYPE 0 NEW
7. OF
WORK 0 BLD.
TO
Split Entry
Split Level
Rancher
O ALT.
❑ PLMB.
❑ AD N.
MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
- CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8' SNSrgLL. MOAT Pump He10-4'i iv It- ELECT/47C Fu2N. 5/.2Q4'-25
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities
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 7'/7-810 SIGNATUREocLCiYUC/
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
LE'IOME OWNER'S WARRANTY
WS ❑
NO ❑
SPECIAL CONDITIONS:
DATE
OFFICIAL
APPROVED F
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ /3,00
M
PERMIT NUMBER
8o- 7VV/
DATE
44 *1300
*1300 16
*13006
E *000
7437B
07=21'-8O
•
2 6479. .
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOME A PERMIT.
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