1980, 01-15 Permit: 80-262 Heat PumpPLAN NUMBER
APPLICATION/ PERMIT
PERMIT NUMBER
-16 ^ -;'(,-Z
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
(jv
DATE
APPLICANT: COMPLETE NUMBERED SPACES'`- PRESS HARD TO MAKE 4 COPIES
* * C Q
G49.
JOB ADDRESS �
LEGAL DESCRIPTION — SEE ATTACHED
* C Y
�QQ�
LOT
I BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
CC
�.
L C
OWNER
P ON
q a 133
3.
1�
ADDRESS
ZIP
Required Set Backs in Feet
\"1.Q
North South East West
Q 1 — 1 5 — 8 Q
CONT ACTOR
PHONE
Size of Parcel
Zone Classification
c rti� t
� � �� .
3 - 4��
26479.
4.
ADDR SS1-jI
Type Con st.
Occupancy
Sprinklered
�`f \ ��V-Qi
9 c):/
❑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.
�r
TYPE ❑ NEW 11 ALT. 2 AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF,.._?,//
El11P
BLD. PLMB. -MECH:
OTHER
El M. H. POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE RK
8 FEES COLLECTED
VALUATICM
Source GASL,ECTRIC
WATER
SEWER
9.
of
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 onstruction.
Plumbing
j,C�
-�
DATE `^
SIGNATURE y % Mech.
SPECIAL APPROVALS
SPECIAL DITIONS:
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 SPACE,
SEPA Checklist
/� /� THIS BECOMES jCOMjES A PERMIT.
h-
DATE H `-q6 nFFICIAI
n.