1983, 04-13 Permit: 83A2908 Heat PumpAPPLICATION/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 ADDRESS
E 119b4 -
LOT
BLOCK
SUBDIVISION
£i.Au.)1.1
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNEN
ADDRESS
oeOon1 kvI�►�st ic1<I�
4.
5.
J/t► f L
CONTRG 4
ADDRESS \+
c
DESIGNER
ADDRESS
leilob
Required Set Backs in Feet
North 'South
East
'West
nel
48444078
Size of Parcel
Zone Classification
o e N L
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
NEW ❑ ALT. ❑ AD'N.
❑ BLD. 0 PLMB. MECH:
❑ RPL. 0 MVE.
0 OTHER
❑ M.H. 0 POOL
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTI FICATE
of EXEMPTION
—„Q.,ESCRIBE WOR
8. 14- � Nt v1 yv ////JJ�� s s m w/1 x gtVY
VALUATION Source GAS ELEdT'R�IC WATER SEWER
of 1 l
9. Utilities
Req'd.
Recd.
Not 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 state or local laregulating 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 CON IONS:
f5K0 EI6 c, eACv_
(`" 1be ISt4 0,o()) 'NS
4.2,000 -443-11
DATE / 4/ 7OFFIC AL �•
nnnnnt n rn iccnnnirr
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
-.SEPA
Mobile Home
Other (Specify/
PERMIT NUMBER
DATE
Uti-* *1900
* 1 9.006
A *000
29078
04"13-83
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0.4'-1`3-83' 290.82 *19.00°
7-,CALE
ao'
IO1. 27'
Noe-
12'
c+ '
4t):
•
1.0-r
6-7
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