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1980, 04-17 Permit: 80-3611 Heat PumpPLAN NUMBER CAI 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 ADDRE/ 7/ 7 !� LOTS BLOCK SUBDIVISION �-/,l LEGAL DESCRIPTION - SEE ATTACHED OWNE ADD Gtr ,a: a.�.J2> PHONE qgq . `3/0 29,010,6 PARCEL NUMBER/S CONTRACTOR 4. A/YQS-rn.o If�ccrf..n9' �o5.7 try t7t1 DESIGNER 5. P ONE ao PHONE ADDRESS ZIP Required Set Backs in Feet North 'South [East 'West Size of Parcel I Zone Classification Type Const. Occupancy Illrll Sprinklered ❑Yes ❑No 0 Req'd. Valuation Building Area in Sq. Ft. DWL Area I Basement Area Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Split Entry Split Level Rancher ❑ NEW LI BLD. ❑ ALT. O PLMB. AD N. 0 MECH. ❑ RPL. ❑ M.H. O MVE. O POOL ❑ OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. 8. DESCRI• BE.WOj2K i`'%C2/ �[a /t&_ t- ERS' �`�,4SE WE fp VALUATION Source / /CT of 9. Utilities 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 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. DATE SIGNATURE DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS:' FOR GAS: PIPE SIZES: PIPE LENGTHS: BTU'S: DATE'T/ 17' N J OFFICIAL r Ca. ne.Vs APPROVED FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ cy Oa Ckt DATE 1///7 / Fd PERMIT NUMBER 3Cn 04* •*9.00 *9,00 *9.006 E *Q00 8 361.02 04-,17-80 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 14:117;!-4 p, 3'611 * 9. IM CO U W d h