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1983, 08-24 Permit: 83A-8128 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY 09A "8►7$ C-- NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES STREET ADDRESS PARCEL NO. 1. E. 12705 - 12th ,. _; t",._. LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: :, i) C 2. OWNER PHONE PHONE rt 3. Carl Teufert 926-6431 g 1 2 7 MAILING ADDRESS ZIP Actual Set Backs in Feet to: E. 12705 - 12th 99206 North ISouth East I West L) —2 1! — CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ ii c 4. Sturm Heating 11/6/83 , 325-4505 Commercial❑ 2 c ' ADDRESS ZIP Type Const. Occupancy Sprinklered E. 204 Indiana ❑Yes ❑No ❑Req'd. DESIGNER PHONE 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. TYPE No.Baths No.Floors No.Fin.Rooms No.Dwellings NEW EI ALT. ❑ AD'N. ❑ RPL. ❑ MVE.7. OF ❑ OTHER WORK El BLD. ❑ PLMB. CR MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No Number or Variance Received Yes❑ No❑ 8. DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑ Heat Pump & 00 amp S rvice Yes❑ Not Applic.❑ Received ❑ VALUATION SOURCEOFGAS ELECTRIC PUB IC❑ SSEWAGE EPTIC❑ Ownership FEES COLLECTED 0 9 UTILITIES XX PRIVATE 0 SEWER❑ Public 0 Private 0 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 th performance of construction.SEE REVERSE SI!, FOR REQUIR D INSPECTIONS Plumbing OWNER OR AGENT A finSIGNATURE OF ,�� ...i_./ DATEAPPLICATION era Mph 16:;Q SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) v Plan Check PRELIM. FINAL DATE Env.Health SEPA Planning Modular/ Fire MFG.Home Prevent. g- O Engineer Other(Specify) U UJ 14.00 J_ Utilities 11- TOTAL $ SEPA PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE, Plans THIS BECOMES A PERMIT. Exam. JJ/ PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED TcBuilding t °/ IN 180 DAYS QQ g 4 8"3 12, 8 5 *14. 0 0 ° 1' DATEQS3ilE� PERMI70. z �O AL