1980, 05-19 Permit: 80-4913 Heat Pump MEM APPLICATION/PERMIT PERMIT NUMBER ,
SPOKANE COUNTY — BUILDING CODES DEPARTMENT M ��Q 19)
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HAIR.DD TO MAKE 4 COPIES C 4 * 9, 0 0
JrDRESS
1. / 47.� Y S .ci' c; LEGAL DESCRIPTION - SEE ATTACHED * 9. 0 0
OT BLOCK SUBDIV SION �f rT / PARCEL NUMBER/S
2. / * 9. 006
3. ow ANER APs // y/r, 17'9i � I 04''5i/ E * 0,0 0
ADDRESS Z Q Required Set Backs in Feet 4 9 1,2 z
North (South East (West 0 5- 1 9-8 0
CO TRACTOR PHDNE Size of Parcel Zone Classification 7 9
4.
Cg
'R J5. 4...........7/ r ZIP Type Const. Occupancy Sprinklered
1 ' / ! r '71 r- c 26 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area r Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE No. Baths No. Floors No. Rooms Rec. Room
❑ NEW 0 ALT. AD'N. 0 RPL. ❑ MVE.
7. OF 0 OTHER
WORK 0 BLD. 0 PLMB. 0 MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DES IBE WORK i
8. 14-0 P—,C-2—,-"V#C FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities
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 construction. Plumbing
DATE SIGNATUREOpp 00
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health FOR GAS:
SEPA
0
Planning PIPE SIZES:
U
1,1
Fire Marshall Mobile Home °'
PIPE LENGTHS: z
Co. Engineer Other (Specify)
BTU'S:
Utilities Q
_SEC-
TOTAL $ -t
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
��A� THIS BECOMES AR PERMIT. 1 (� (}
DATES! FFICIAL J 'Y�) V !:- 1'9 -8 0 - 7 1. 3 �Z ,* 7. O 0 d H
APPROVED FOR ISSUANCE