1981, 09-15 Permit: 81A-9343 Heat PumpPLAN 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
1.
JOB ADDRESS
(
LOT
2.
BLOCK
�{�
JUBDIVISION 9
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNER
A'DRi�SS.
` 7,, r:k) ,4fL 7/
CO TRACTOR
4. �! i
A••RE
DESIGNER
5.
6.
ADDRESS
PHONE
ZIP
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
CHANGE OF USE FROM
TO
PHONE
ZIP
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
Main Floor
Area of Decks
Upper Floors Garage Area
Finished Basement
Storage
Unfin- Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT. ❑ AD N. 0 RPL. 0 MVE.
O PLMB. bQ MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
9.
D SCRIBE WORK �p
VALUATION
SOURCE
OF
UTILITIES
Enum. Dist.
Location (Area)
GAS ELECTRIC
WATER
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 SIDE FOR REQUIRED INSPECTIONS
/ATE OF APPLICATION
SIGNATURE OF APPLICAN'L _J
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
(/)eJ-4 lz��GcJD �
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /9 r
'7
PERMIT NUM ER. ,
0l
04* * 1 9.00
* 1 9.00
* 1 9.006
A *000
934.22
09-15-81
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
091—I�c�';_O 1'
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
z *1
PERMIT NO. TQ