1980, 08-27 Permit: 80-9194 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
Ea.t 13204 - 10th. Avenue
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
Phil D,irbAnnnn
PHONE
PARCEL NUMBER/S
ADDRESS
E 13204 - 10th. Avenue
ZIP
99216
Required Set Backs in Feet
North !South
East
'West
4
CONTRACTOR
ADDRESS
PriwonA Tnronponated
F 6507 bin9Pnn Avonue
PHONE
535-7714
Size of Parcel
Zona Classification
ZIP
99206
Type Const.
Occupancy
SPrinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
ADDRESS
ZIP
OWL Area
Basement Area
iBuilding Area i Sq, Ft.
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
O BLD.
O ALT.
O PLMB
AD N.
MECH:
0 RPL.
• MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Not Req'd.
DESCRIBE WORK
Add Can
VALUATION
PA lent pump
Source
Utilities
to pJeag.nt Ayetem
GAS ELECTRIC
WATER
SEWER
I hereby certify that I have re d and exam ined this applied ion and have read the "NOTICE"
on reverse side, and know the same to b true and correct. All provisions of laws and ordin
type of work will be complied with whe her specified her in or not. The granting of a permi
to give authority to violate or cancel theprovisions of any other state or local law regulating
performance of construction,
DATE SIGNATURE
provisions included
nces governing this
does not presume
onstruction or the
DEPT.
SPECIAL APPROVALS
REO'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Util pies
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
OFFICIAL d(A ( 2 a
FEES COLLECTED
Single $
Building
Plumbing
Mech-
Plan Check
SEPA
Mobile Home
6 00
One m pe ify) 3.00
TOTAL $ 9 fin
M
T NUMBER
8o -9,99'
n
DATE Auauet 26. 1980
4.
0103-.
*r 0
9.
WHEN MACHINE VALIDATED IN THIS SPACE
THIS BECOMES A PERMIT.