1980, 03-11 Permit: 80-2053 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT /
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE � . (O
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
G4 * * 9.00
JOB ADDRESS
1. )4'=Z ti U LEGAL DESCRIPTION - SEE ATTACHED * q 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 9 r, C
2. V
P N E E i. 0 0 l 3(�
OWNER
3. _ a1V -� 1�?lr.
ADDRESS � ��� ZIP Required Set Backs in Feet 2 0 5 2 2.
At ,,-x-_, North 'South East (West 0 3— 1 1 —8 0
CONTRA. OR 31,L,r__
PHONE Size of Parcel Zone Classification..s •� A 'ti �3a.-ci5i?S~ 6 4 7 9,
4. ADd-ES / ( + Z P Type Const. Occupancy Sprinklered
L. 40cl ZA d.�( ..0.3 07 ❑Yes ❑No ❑ Req'd.
DESIGNER ! �►��k"�' 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.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORKOCisource
n
8. FEES COLLECTED
VALUATION GAS ELE TRIC 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 . e or local law reg. : 'ng construction or the
Plumbing
performance of construction. �r
DATE
to O (v) SIGNATU' / „vs.. - # 4,4..)C% "-) Mech.
SPECIAL APPROVALS SPEC , ONDITIONS: .13
DEPT. REQ'D. REC'D. Plan Check
Env.Health
cx
SEPA o
Planning _ w
Cl—
Mobile
Mobile Home rn
Fire Marshall —
Co. Engineer Other (Specify) 1
Utilities 0v
TOTAL $ `
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
{ � tJl 1 —8 0 2 , 5, c7 * 7.
O 0 LIf0:.. asri .et .. ,, 'ai,i ; DATE3 II' �OFFICIAL r1t ���+,,_„
APPROVED FOR ISSUANCE _