1984, 02-02 Permit: 84A-916 Heat Pump PLAN NUMBER APPLICATION/PERMIT PEI1AITNUMBER9I
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY -
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. ?o4 S . UV��S/ �(-
LOT BLOCK SUBDIVISION ( LEGAL DESCRIPTION:
2.
OWNER ,—, 1 ,. PHONE PHONE
3. ilaki c' (Th HOCC.,
MAILING ADDRESS� ZIP Actual Set Backs in Feet to:
-7 f'i I)E North 'South I East I West
CONTRACT LICENSE EXPIR PHONE _ Size of Parcel Zone Classification Residential❑
' Commercial❑
4. LS.Wt.(I '[C. 1 tiC.- I o _53 --7333
ADDRESS CcZI Type Const. Occupancy Sprinklered
7 : l /r) e/�,(>� ❑Yes ❑No ❑Reg'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse I.
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK CIC
BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ertifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No
DESCRIBE WORK /)],'r,• `/ , et;r')ne c 1~ Shorelines/Flood Hazard Plans Required❑
8. --11—.n.Sttt i 'NCCte -K.4./ ? 101</it ) {'.) ^L7_ICIL kXl /At`C/j Lfi'2/L' Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELF�CT,RIC WAFER @SWAGE Ownership FEES COLLECTED
.c./.4r PUBLIC❑ SEPTIC❑
9. UTILITIES PRIVATE 0 SEWER❑ Public❑Private❑
)
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 Building
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction.SEE REVERSE SIDE FO REQUIRED INSPECTIONS Plumbing
SIGNATURE OF '1) a 7.3/4,;i/APPLICATION I Mach.
OWNER OR AGENT T[[ C d DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular/
MFG.Home
Fire a
Prevent. O
Engineer Other(Specify) NJ
J
9 J
X.
Utilities TOTAL $ ' '-
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building (r/ /` IN 180 DAYS r n QQo nOTech. J 2-/'7 DATE EDU 2 0 4 PERMIT N09. z * J' O I�tAL