1982, 04-08 Permit: 82A-2622 Heat Pump, FurnacePLAN 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
LO
BLOCK
SUBDIVISION
2.
ow
3.
4.
A D C}ftE� .2,
DESIGNER
5.
ADDRESS
j LEGAL DESCRIPTION - SEE ATTACHED
ZIP/1na `h
PHONE
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor Upper Floors
Garage Area
Storage
CHANG. OSE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT. ❑ AD'N.
❑ PLMB. /MECH.
❑ RPL. ❑ MVE.
❑ M.H. ❑ POOL
❑ OTHER
Area of Decks
No. Baths
Finished Basement
No. Stories
No. Rooms
Unfin. Basement
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
6, S C R I
•v,/VALUATION
E W.10 F3 K
Enum. Dist.
Location (Area)
9.
SOURCE
OF
UTILITIES
GAS
EL: T'IC
WATER
4,
SEWER
Ownership
Public ❑ Private ❑
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 construction or the
performance of construction. SEE REVERSE
/�G F' !iL- REVERSE SIDE FOR REQUIRED INSPECTION �/f�
DATE OF APPLICATION �� SIGNATURE OF APPLICANT /L��//�
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
V inghnician
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ IC( -co
PERMIT NUMBER
gip —�Co�,- I
04* * 1 9.00
* 1900
* 1 9.006
A *000
262.1
04-08-82
6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0`4-0&+82
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
26222 *19.00a�
PERMIT NO. TOTAL