1980, 06-27 Permit: 80-6445 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 1 D 6*17
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES ,- l:- * * 9.0 0
JOB ADDRESSLEGAL DESCRIPTION - SEE ATTACHED
s * 9C 1_.
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. 2 n
[_1 J
OWNER PHONE }l, L,L 4. 4-
3. ' Lj /kf^oRL3 9 ..
AD ESSRequired Set Backs in Feet }h,- ^ " r'
/7 907 �, c —�U
ZIP��Q/� North (South East (West L
C NTRACTOR _ PHONE Size of Parcel Zone Classification o.4 ! 9.
,g �
4. 15f3Vii✓ i'', 4/%64 eF "�-2/eG j_27%t/C, S—Y,,S=/7//
ADDRESS ZIP Type Const. Occupancy Sprinklered
M 722-
y /�ILCG-IL ✓ /� ""r-.202- ❑Yes ❑No 1=1 Req'd.
DESIGNER !� PHONE/ Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area I Basement Area Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. El AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK El BLD. ICI PLMB. leMECH: CI M.H. CI POOL
of EXEMPTION
DESCRIBE WORK FEES COLLECTED
8. /i1/ 7� 4-T-/'�//7" -- /61//tee .'°i r--0/`r/
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities Single $
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 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 state or local law regulating construction or the
Plumbing
performance of construction.
DATE 6 -,'O SIGNATU- I �'l''1 "G' Mech. . 9ed
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health cY
SEPA c)
I--
J
Planning — c'u
ci
Mobile Home `n
Z
Fire Marshall —
Co. Engineer Other (Specify)
Utilities rid
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist n 1-' 0' 6' 2'/•- 3 0 6 4 1: 5 ,, k 9, n L) oa. F1
ti '. DATE 6 �7 0� AIN." ..
A'''T'"`i FOR ISSUANCE -