1980, 07-07 Permit: 80-6702 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.
2.
3
4' ADDReSSE • cO</.
JOB ADD SS
LOT BLOCK `Sj/UUBDIVVIISIOT1
OWNER
ADDRESS GJ"" " —
CONTRACT
LEGAL DESCRIPTION - SEE ATTACHED
tZ
ONE
ala -/.o 96
ZIP
99/fr
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South East (West
PHONE
ZI
ya0%
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation 1Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors • Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
E ALT.
E PLMB.
AD'N. ❑ RPL.
MECH. D M.H.
❑ MVE.
O POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE W
8.
VALUATION
9.
Iforic
SOURCE
OF
UTILITIES
Enum. Dist.
Location (Area)
GAS
E,�E� RIC
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 INSPEC,[j S
DATE OF APPLICATION b"-0)740
SIGNATURE OF APPLICAN
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bi Tec nician
FOR GAS APPLICATIONS
PIPE SIZES
PIPE LENGTHS
BTUS
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL •
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check ie`
SEPA
Mobile Home
Other (Specify)
TOTAL $ 9,oU
PERMIT NUMBER
04* *9.00
* 9.00
* 9.006
E *000 g
67012
07-07-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1017;`,-017'-.8.0 670.25
*9.00° -