1980, 04-17 Permit: 80-3609 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES r- PRESS HARD TO MAKE 4 COPIES
JOB9ODR ESS
J . / 9 /a zA:m-La)
9976
LEGAL DESCRIPTION - SEE ATTACHED -
LOT
2.
BLOCK
SUBDIVISION
4.
5.
OWNER
AD DRE55
CO PST RA R
ADDR S
p r—
DESIGNER
OLC.o
7'c.
PHONE
2
•PHONE i��
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South [East (West
Size of Parcel 1 Zone Classification -
Type Const.
OccupanCY
Sprinklered
Dyes ❑No ❑ Req'd.
Valuation • I Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I •Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
8.
9.
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
DESCRIBE WO
VALUATION
O ALT.Ca0 AD N. 0 RPL. 0 MVE.
MECH: 0 POOL
O PLMB.
Source
of
Utilities
P
❑ M.H.
GAS
0 OTHER
ELECTRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
WATER
CERTIFICATE
of EXEMPTION
SEWER
Req'd.
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 std or local law regulating construction or the
performance[- cpn�(ruction.
DATE OVv
SIGNATOR
DEPT.
SPECIAL APPROVALS
REQ'O. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL' CONDITIONS:
DATE
FFICIAL
. Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
3/.0�0
ea
Plan Check -k
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
DATE T—/11a d
04* *9.00
*9.00 ✓n
*9.006
E *000 E
3608�
04'=1.7-80
i 6479
CC
O
U
— w
0 -
APPROVED FOR ISSUANCE
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
n•071.17H8131 3.6Q'9Z *9.00U