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1980, 05-27 Permit: M80-5003 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 JOB ADDRESS 1. LOT 2. - I ! LEGAL DESCRIPTION - SEE ATTACHED BLOCK SUBDIVISFO PARCEL NUMBER/S 3. OWNER ADDRE h42 \3atEe1-c IozkCi_ PHONE ZI P Actual Set Backs in Feet North 'South [East (West 4. CONTiRt CTO3�� 1. LL; ADDRE - .))"Q 4 (LI V DESIGNER 5. ADDRESS PHONE 3'24,- 500C ZIP cOo PHONE Size of Parcel 1 Zone Classification Type Const. Occupancy Sprinklered Yes ❑No ❑ Req'd. Valuation (Building Area in Sq. Ft. ZIP Main Floor I Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE rfd NEW ❑ ALT. ❑ AD'N. ❑ RPL. ElMVE. 7.WORK BLD. ❑ PLMB. /MECH. ❑ M.H. ❑ POOL OF ❑ OTHER No. Baths No. Stories No. Rooms No. pf Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DE RIBE WORK 8. / Lu-rt_iD VALUATION SOURCE AS ELE R)C WATER SEWER OF rrYY// 9. UTILITIES Enum. Dist. I Location (Area) � I 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 INSPECTIONS I DATE OF APPLICATION SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist nrirreii.Q.Cechn SIGNATURE OF APPLICANT SPECIAL CONDITIONS: 0 PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building Plumbing )Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 10 rtMIT NUMBER 04* *9.00 *9.00 17) *9.006 E *0,00 0 5002E 05-27-80 B 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 05,,27-80 500.35 PERMIT FXPIPPC ONF VFAR FROM DATF OF ISSUANCE DATE ISI IFIL *9,00° - PFRMIT NO TCTAI