1980, 11-04 Permit: 80B-3201 Heat PumpPLAN NUMBER
JOB ADDRESS
1.
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
yr
LOT
1 n( l 9 nitBLOC SUBDIVISION
•
LEGAL DESCRIPTION — SEE ATTACHED
DESIGNER
5.
ADDRESS
PHONE
4 lo—af6'2
21Li
90)/ 1,0
PARCEL NUMBER/S
Actual Set Backs in Feet
North South `East IWe
PHONE Size of Parcel
Qao7
PHONE
Type Const
Valuation
Occupancy
Zone Classification
Sprinklered
Oyes 0No 0 Req'd.
Building Area In Sq. Ft
ZIP
Main Floor
Upper Floo
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basemen
TYPE
7. OF
WORK
0 NEW 0 ALT. ErAD N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. a MECH. 0 M.H. 0 POOL
0 OTHER
No. Bath
No. Storle
No. Rooms
No. of Dwelling
CERTIFICATE
of EXEMPTION
Req'd.
Recd
Not Req'd.
DESCRIBE WORK
S.
sl�S J
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE GAS
• OF
UTILITIES
ELEL'T RIC 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 INSPECT S
DATE OF APPLICATION
/0- a9 -cO
SIGNATURE OF APPLICANT OJ TL2Yt a 1'lv0
SPECIAL APPROVALS
NAME DATE
Ent Health
Planning
Fire Marshall
Co. Engineer
Utilitie
Plans Examiner
SEPA Checklist
Building Te hnicia
O,r � oa4.f.Ti&
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
•
Single $
Building
Plumbing
Mech.
Plan Check f p•vb
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 7 �—
I4
PERMIT NUMBER
D;C3 .2..0/
04* *9.00
*9.00 N
*9006
A *Q00
320.'0R
11-04-80
2. 6479.
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04'^80 3:2.011.
DATE ISSUED PERMIT NO.
*9.0.0 Re-
TOTAL