1984, 03-07 Permit: 84A-1908 Heat Pump PLAN NUMBER APPLICATION/PERMIT PRMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY lA — (ct'-' '
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PREAS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. //%/ re,"e–,,4.,'
LOT-- BLOCK IVISION LEGAL DESCRIPTION:
2.
OWNER t� PHONE PHONE
�idu de. C' C-'^G
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
--,i Pi North 'South `East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ el ;,
4. x/77. ?;'/'S Ze71. ' Commercial❑
ADDRESS �/ ZIP Type Const. Occupancy Sprinklered ,) :`
7...5-2 /fl2 .,/ 99 Zoo ❑Yes ONo ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area =
5. - 1
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW 0 ALT. [WAD'N. ❑ RPL. ❑ MVE.7. OF ❑ OTHER
WORK
CI BLD. ❑ PLMB..QGMECH. LI M.H. El POOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes Non
DESCRIBE W K ;, j Shorelines/Flood Hazard Plans Required❑
8• —4-1---<'Oa 7e.7M'et_ -c4" Yes Not Applic.❑ Received ❑
VALUATION SOURCE GAS G/ ELECTAIC WATER SEWAGE Ownership FEES COLLECTED
9. OF
UTILITIES PUBLIC❑
PRIVATE❑ SEPTIC❑
SEWER El 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 FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF / APPLICATION
OWNER OR AGENT .0' i./ DATE -r— Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning
Modular/
I MFG.Home
Fire
Prevent.
O
Other(Specify) V
Engineer LU
J_
Utilities ru LL
TOTAL $ -G
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 7 1
Building
9:ir
IN 180 DAYS DATE�ISS)UE� / -n PERMIT NO. z * U. TO`rAL
Tech. /