1980, 06-10 Permit: 80-5559 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT P/\4: W°-- Ci
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
o L %3`- - r ,.LGAL DESCRIPTION - SEE ATTACHED 0 4 * * 9.0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 9 0 0
2.
OWNER PHONE * 9'0 0 U
3. -5.3. -7.5-OS, - E * 000
ADDRESS ZIP Actual Set Backs in Feet
Ala 99ao o North 'South East 'West 5 5 5'8 g
CONTRACTOR P ONE Size of Parcel Zone Classification
4' ADDRESS" i l Type Const. Occupancy Sprinklered -2 6 4 7 9.
�v� I' 0 • V9�0'/ Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ NEW ❑ ALT. 11.ti AD'N. ❑ RPL. 0 MVE.
7. OF ❑ OTHER
WORK
0 BLD. 0 PLMB. rid MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
r
DESCRIBE WORK ( 7,vp Enum. Dist. I Location (Area)
8. ,� nL�^�Ti) p(l /�,y FEES COLLECTED
VALUATION SOURCE GAS ELECTRICTRWATER SEWER Ownership USE CODE
OF 9. UTILITIES xV� Public D Private 0
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
performance of construction.SEERREVERSE SIDE FOR REQUIRED INSPEC,,•NS Plumbing
DATE OF APPLICATION c7 SIGNATURE OF APPLICANT' /e% ` • Z--).-d-64--i Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: FOR GAS APP ' •TIONS d�
NAME DATE Plan Check �'
Env. Health
PIPE SIZES
SEPA 'i
Planning 0U
PIPE LENGTHS Mobile Home
Fire Marshall
U-
BTUS •
Co. Engineer Other (Specify)
Utilities TOTAL $ 19-V
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
ng Tech is an PERMIT IS NONTRANSFERABLE 0 -6'-10 - 8 0 5 5 5.9 0 * 9, 0 0 a -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL