1984, 03-19 Permit: 84A-2365 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT RUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY ''4T-A
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES- PRESS HARD TO MAKE 3 COPIES
STREkT ADDRESS PARCEL NO.
1. 4 l-7 _ ;-7E- Klrr
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
O NER PHONE PHONE
3. �, 7)5 - 177.0
MAILI G ADDRESS ``. II ZIP Actual Set Backs in Feet to:
Fres -'-7 3'3« IXOCJN\ t North ISouth East I West
CO TR, �, ;G ICT LICENSE EXPIRES P 1 Size of Parcel Zone Classification Residential❑
,�I7�J . GaQ Commercial❑
4. ADDRESS
I f � IP Co Type Const. Occupancy Sprinklered
Oyes ❑No ❑Req a.
k
DESIGNER PHON New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. -
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 W ❑ ALT. ❑ AD' ❑ OTHER N. ❑ RPL. ❑ MVE.
7. OF
WORK ❑ BLD. ❑ PLMB. p--MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No In Number
or Variance Received Yes Non
8. DESCRI , 1,s1
I19L�C� Shorelines/Flood Nolood plazar ❑d Plans Required 0
Received ❑
VALUATION �If SOURCE GA� ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9. PUBLIC 1=1 SEPTIC❑
PRIVATE❑ SEWER❑ Public❑Private❑
UTILILITIES
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 OFAPPLICATION
OWNER OR AGENT DATE " ( +"F Mech.
Plan Check 0-
SPECIAL APPRO /A SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINIAL DATE
Env.Health
SEPA
Planning Modular/
MFG.Home ).-
Fire 3.
Prevent. O
Engineer Other(Specify) W
J_
Utilities 21
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building � IN 180 DAYS 3 =1 9 8 4 � 6, 5 z * 2 0. 0 0 4d;AL
DATE-ISSUED PERMI