1980, 06-30 Permit: M80-6473 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE June 27, 1980
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
PERMIT NUMBER
86 Ccf7�
1.
2.
JOB ADDRESS
Ea -t 5724 - 19th. Avenue
LOT SUBDIVISION
BLOCK
LEGAESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
3.
OWNER
ADDRESS
Sunt Coopers
Ea4t 5724 - 19th. Avenue
PHONE
ZIP
99206
Required Set Backs in Feet
North (South [East West
4.
CONTRACTOR
Powe ns, Inc onpoActle d
ADDRESS
PHONE
535-7714
Size of Parcel 1 Zone Classification
Fat 6507 Matton Avenue
ZIP
99206
Type Const.
Occupancy
Sprinklered
❑Yes ENo ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area
Basement Area 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
X AD N.
® MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Add CanA ic.
VALUATION
9.
Heat ?ump To P)feAen.t
Source GAS ELECTRqC
of
Utilities
WATER
SEWER
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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
HOME OWNER'S W PDAM-r ,
YES
SPECIAL CONDITIONS:
DATE OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Mech. 6.00
Plan Check
SEPA
Mobile Home
Sheh1 4Ay) 3.00
TOTAL
$ 9.00
0..1.2c1
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06s -3:G-80
647.32 *'9.00,
INCPCrTnD