1980, 02-05 Permit: 80-903 Heat PumpPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH Bit JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOBADDRESS 11 R /) ,,✓IA LEGAL DESCRIPTION—SEE ATTACHED
3.
4.
❑ye,
5. ADDRESS
ZIP
DWL Area I Basement Area
I Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
I Spin Level
I Rancher
s.
No. Baths
No. Floors
No. Roams
RIC. Room
TYPE NEW ❑ ALT_ AD -N. ❑RPL. ❑ MVE.
], OF OTHER
13 BLD. ❑PCMB. MECH: ❑ M.H. ❑POOL
CERTIFICATE
Re0'0-
ReC•d.
Not Read
WORK
M EXEMPTION
DESCRIBE WO K
FEES COLLECTED
8.tl�kj
VALUgT10N
Source
GAS
E T IC
WATER
SEWER
at
Q,
Utllltles
Single $
1 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 tat or local law ting construction or the
Plumbing
performance of construction.
p
DATE o�'S- 5a SIGNATURE
Myth
5;6=
SPECIAL APPROVALS
SPECA ONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
any. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Sp.ify)
Co. Enelneer
' X
Utilities
TOTAL $
Zone clearance
WHEN MACHINE VALIDA'
THIS B1ECOMES A PERMIT
SEPA Checklist
� �
O 1 O 6-510'
DAT EA(OFFICIgL
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�MPERMNUMBER IT �-o
DATE
04* *9.00
*9.00 ti
*9.006
E *G00 S
9G29
01-06-80
2 6479.
903 *9.00.aJP