1980, 05-07 Permit: 80-4406 Heat PumpAPPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3COPIES
Ye'r' �''+r►
1.
JOB ADDRES
13
`2.
3.
4.
5.
LOT
OWNE
ADDR
CONTRACTOR
BLOC
�S BDIVISION
LEGAL- DESCRIPTION — SEE ATTACHED
ss
t
DESIGNER
P ONE
Va 4,
ZIP
99 Qd4
PHONE
&546a5 -
J9&o7
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North !South
Size of Parcel
Type Const.
Valuation
Occupancy
East 'West
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
ADDRESS"
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin: Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
IAD N. 0 RPL.
MECH. 0 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 WOR
6:L ' " 6
8=
9.
VALUATION
SOURCE
OF
UTILITIES
GAS
Enum. Dist.
Location (Area)
8LE0CTRIC
WATER
SEWER
Ownership
Public ❑ Private 0.
USE CODE
I hereby certify that !'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 construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION v � Oo SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
eehnician
SPECIAL CONDITIONS:
FOR GAS APPLI IONS
PIPE SI?ES
PIPE LENGTHS
BTUS
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check az
SEPA
Mobile Home
Other (Specify)
TOTAL `$—I `°1°
PERMIT NUMBER
L1 at:Ya_
04* *9.00
*9.00 5
*9.006
E *Q0
440,52
05-07-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i5i"1017 77,
DATE 'ISSUED
4'4'0.6 Z *9.0`0;x,1 —
PERMIT NO. TOTAL