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1980, 04-18 Permit: 80-3662 Heat PumpPLAN NUMBER 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. 3. JOB ACID :SS j / g o ` ^) ^I 1a yV iotaLOT �Ca SUBDIVISION BLOCK LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S OWNER ADDR 4.. 5. ES CONTRACliktho 07rs. ONE PCin Lo 203 Z199do Required Set Backs in Feet North 'South East (West ADD DESIGNER anti?, f`Y'nC PHONE - Sas- 235 Size of Parcel • Zone Classification PHONE Type Const. Valuation Occupancy Sprinklered ❑Ves ❑No ❑ Req'd. 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 7. OF WORK 8. 9. ❑ NEW ❑ BLD. DESCRIBE WORK VALUATION ❑ ALT. o PLMB. AD N. 0 RPL. MECH: 0 M.H. Lc 0 iCP Source of Utilities GAS ❑ MVE. ❑ POOL 0 OTHER ,gLECTRIC No. Baths No. Floors No. Rooms Rec. Room WATER CERTIFICATE of EXEMPTION SEWER Req'd. I hereby certify that I have read and examined this applica ion and have read the "NOTICE" provisions included on reverse side, and know the same to be true and correc . 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 regting construction or the performance of construction. DATE DEPT. 4 -12 --go SPECIAL APPROVALS ' REQ'D. REC'D. SIGNATURE Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIALQ:ONDITIONS: • DATE14111>iissJ OFFICIAL 51U#�QAAAAX3Y\ APPROVED FOR ISSUANCE Rec'd. Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) t32•0° TOTAL $ %•OJ PERMIT NUMBER A -W- 3c:6a DATE 4-171 - 90 04* *9.00 *9.00 N *9.008 E *Q00 8 3661R• 04-18-80 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMESA PERMIT. -I p.14:r �1', VQ..8101 3'6 'b' 2 2 >*7.00.2p CC O Ca Ca 1 w V)