1980, 01-09 Permit: 80A-9951 Heat PumpPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
M C6oJ _a
DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
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JOB ADDRE iI
LEGAL DESCRIPTION - SEE ATTACHED
1. �3 , J309 MICA (?ARW
9
LOT
BLOCK
ISUBDIV151ONPARCEL
NUMBER/S
2.
E n
OWNER
PHONE
3.
'9
9 1 C `=
ADDRESS
ZIP
Required Set Backs in Feet
i e
/13
North South
East West
01 — 0 9— Ij 0
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
Y E�e E4 dlelCCAJ i
- `
<_ 6.479.
4.
ADDRESS
IP
Type Const.
Occupancy
Sprinklered
_
E.
� �a�In?.
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
split Level
Rancher
6.
TYPE 1:1 NEW El ALT. �AD'N. 1:1 RPL. ElMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
11 BLD. ElPLMB. 1-1MECH: ElM.H. El POOL
WORK
of EXEMPTION
DESCRIBE WORK
�I iQ AJ
8 —FP" AT
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities X
Single $
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
Building
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.
Plumbing
DATE SIGNATURE _
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ -D. RECD.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS 5PAC; .,
SEPA Checklist
THIS BECOMES A PERMIT.
—Q—(R �JOFFICIA�I��y1
DATEA/i�
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