1980, 05-29 Permit: 80-5103 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 3•COPIES.
1.
2.
3
JOB ADDRESS & .•� �roicL
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
at ki NP.As,cs
ADDRESS %
CONTRA TOR
4.
/
aos
ONE
ciCla4
ZIP
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East 'West
5.
DESIGNER
PHONE
Zao7
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
Dyes DNo 0 Req'd.
Valuation I Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE 0 NEW
7. OF
WORK 0 BLD.
DESCRIBE WORN
8.
TO
Area of Decks
Finished Basement
Unfin. Basement
D ALT.
❑ PLMB.
&AD N. 0 RPL. 0 MVE.
MECH. 0 M.H. 0 POOL
bo P
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE '
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist.
Location (Area)
VALUATI 0
9.
SOURCE
OF
UTILITIES
GAS
LECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPE IS
DATE OF APPLICATION J —ci3— �v
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
8/Ing�Te1c an
I�.t anti-sO Yui
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
FOR GAS APPLIANCES
PIPE SIZES
PIPE LENGTHS
BTUS
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
3.6
(c,,011 •
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $614°
PERMIT NUMBER
M-%O-5fl9
011* *9.00
*9.00 N
*9.006
E *000
5102
05=29-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
t �', 80
51.0,3= �9.00°F
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
0
— J
U-