1980, 04-23 Permit: 80-3856 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
4 SPOKANE COUNTY — BUILDING CODES DEPARTMENT �y{ � ��
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /i /(J ('
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 4 * * 9.0 0
JOB ADDRESS 4 ' LLGAL bESCRIPTION - SEE ATTACHED * ° 0 0
1. , , ISL v c.�c.1.
* 9.006
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. y� '3,344
} E * 0.00 8
OWNER PUONE
c,1{?,Y Ill r-.5 • � �J C:" i� �3 4-< •;(7 3 8 5.5 2
3. TT
ADDRES ZIP Required Set Backs in Feet
\a'.,'\,. -% North 'South [East 'West 0 4-2 3-8 0
CONTRACT 0 ilPHONE _ Size of Parcel Zone Classification f 6 4 7 9.
cis,,- t.,,,_. kl-ti,t..-(.7tml- 4
4' ADDRES _ �-J �(�
/ ZIP., Type Const. Occupancy Sprinklered
t- - C2"/ '1,'(.1 -`(t. 'tJa�–' kV10){,- /I EYes ❑No 0 Req'd.
DESIGNER 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.
TYPENo.Baths No. Floors No. Rooms Rec. Room
0 NEW ❑ ALT. AD'N. 0 RPL. 0 NAVE.
7. OF 0 OTHER
WORK 0 BLD. 0 PLMB. MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
r-NDESCRIBE WORK . 1 , FEES COLLECTED
8. ''� )t.)�tR- ,
Lj
VALUATION Source GASELECTRIC WATER SEWER
of -k Y�
9. Utilities d 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 statp-o{ local law regulating construction or the
performance of construction. ‘ 1Plumbing
I .. �n
DATE -11)._cQ SIGNATURE ,'1,-- - Y` ` 't^._ 6ti--'
Mech. t.7
SPECIAL APPROVALS SPECIAL CkN I,ITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA (15
Planning u
_ ,L.1
O.
Fire Marshall Mobile Home 'n
Z
Co. Engineer Other (Specify)
Utilities t.._4 co
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PE,RMIT. '1 r, , O
1 t n , ;i 56 - * �7,U UL_
DATE61/al/Ty_ OFFICIAL � +�- ,l r' L ' �
iiiii APPROVED FOR ISSUANCE _