1981, 08-13 Permit: 81A-8085 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
JOB ADDRESS
1. L lrS-25
7
3 %Y44 A wo+-ems
LOT BLOCK SUBDIVISION
2.
OWNER
3. k / 6 _rt 3 liZe—st_d /✓frzv
ADDRESS
J Gem
CONTRACTOR
4' ADDRESS 71L�asz. es -0
cr $i E G
PHONE
ZIP
1 LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East 'West
PHONE
SAY V72ir
Size of Parcel Zone Classification
ZIP
9yso G
Type Const.
Occupancy Sprinklered
Oyes ONo 0 Reg'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS '
ZIP
. Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE 0 NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
7. OF
WORK 0 BLD. 0 PLMB. qry MECH. 0 M.H. 0 POOL
8.
DESCRIBE WORK 'L / �/ `E�
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
i Req'd.
Recd.
NOt Req'd.
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTR
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 INSPECTIONS
DATE OF APPLICATION D// y/7/ SIGNATURE OF APPLICANT " `/ G rt41' yc
SPECIAL APPROVALS SPECIAL CONDITIONS: _
NAME DATE / / / '
/s/ a
Env. Health �� 9 / K—fifril
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklis
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM, DATE OF ISSUANCE'
FEES COLLECTED
Single $
Building
Plumbing
/0 -a
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
pi
PERMIT NUMBER
DIk -s065
04* *14.00
*14.00 rt
*14.000
A *Q00 8
80842
08•-1 3-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i'
''olitti3 .,8`11
8108.55? *1;4,00(10
DATE ISSUED PERMIT NO. TOTAL
LLI
J
W