1980, 01-23 Permit: 80-0489 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES-,PRESS,HARD TO MAKE 4 COPIES
1.
2.
3.
JOBADpRESS4 (' CC u-
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER,
•C,1r�Upn��tI
ADDRESS
4.
CONT TOR
ADDR S
rc4
P ONE
ZIP
PHONE
r-tgat
PARCEL NUMBER/S
Required Set Backs in Feet
North !South
Size of Parcel
Type Const.
East !West
Occupancy
5.
DESIGNER
PHONE
ADDRESS
ZIP
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Valuation
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
DWL Area I Basement Area r Garage Area
Storage
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
E ALT.
❑ PLMB.
2 -AD N. ❑ RPL. ❑ MVE.
r
MECH: ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WOR
8.
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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 s, or local law regulating construction or the
performance of construction.
DATE
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env, Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIKL CONDITIONS:
DATE "! OF
APP
D FOR ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. 9
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ci, oc
PERMIT NUMBER
- 24
04* *9,00
* 9.00
* 9.006
E *0.00
48.8
01-23-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01' 2 0' 48.95 X9.00°F-