1980, 10-14 Permit: 80B-1951 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
1.
2.
3.
JOB ADDRESS
104.04 E SINTO
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
Merwin Cederblom
P E2359
PARCEL NUMBER/S
ADDRESS
104.04 E Sinto Spokane
Wa
499206
Actual Set Backs in Feet
North 'South
East
'West
4.
CONTRACTOR
Boyle Fuel
ADDRESSN 1014DIVlsion
PH328ONE
1521
Size of Parcel
Zone Classification
Spokane WA
ZIP 99220
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
J. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
0 BLD.
O ALT.
O PLMB.
InICAD'N.
0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Install& wire heat pump
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
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 g6nstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
lu--16-gb
DATE OF APPLICATION
SIGNATURE OF APPLICANT
�I
-+
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
"ding Te nician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
3.00
Other (Specify) 6 •00
Inspection
TOTAL $ 'D0
14
PERMIT NUMBER
$� 1� — 17(
j4*
* 9,00
* 00
* 9,00
• 0 0 CD,
195,0'
10-1G-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
195.1
*9.00
O J
a.H