1984, 04-05 Permit: 84A-2963 Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER '
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 01A ' 2,16,0
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
111=1111116. 411111NIIIIIIIIIIMINIII
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER \ PHONE PHONE
3. — c'_K`a Ai \NS\‘ ..&L---,`-`�
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
_� C\C-NE: North (South East I West
-CONTRACTO LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ ` C4 �R`- tt: ,�IZ _ I
�� IV1)5 I l �,t5 � S ' � 7.3 Commercial El
ADDRESS ZIP Type Const. Occupancy Sprinklered r c r 0
{{ y ❑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.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL wVari oE empt. Required Yes❑ No❑ Number
Received Yes(7 No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
$. 3 "it,p.; 171Yes❑ Not Applic. Received ❑
VALUATION' SOURCE GAS ELECTRIC
� -041 t cWATER SEWAGE Ownership AL
9• UTILITIESPUBLIC❑ SEPTIC ElFEES COLLECTEDLI
PRIVATE❑ SEWER 0 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 the performance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF 0 APPLICATION
OWNER OR AGENT ` - amu
-. ). *��- • -7— `'0� DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITIO S: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular/
MFG.Home >-
Fire
Prevent. c
C-,
Engineer Other(Specify) LLJ
J
LL
Utilities : f C1 L
TOTAL $ 'T` '
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS 5 - / * n.
0 11)0i-JALTech. / / E/9 DATEGSUEDU PERMIT2N .