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1980, 02-28 Permit: 80-1648 Heat PumpPLAN NUMBER APPLICATION/ PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 PERMIT IVUMBER M -- ►try DATE 04* *9.00 *9.00U E 1 64,7 02-28-80 A 6479, VALUATION Source GAS ELECTRX WATER SEWER APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 9, utilities Single $ JOB ADDRESS I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included LEGAL DESCRIPTION -SEE ATTACHED 1. to give authority to violate or cancel the provisions of any other state or local law regulating construction or the ` performance of construction. Plumbing 1a) SIGNATURE ` LO BLOCK SUBDIVISION SPECIAL APPROVALS SPECIAL CONDITIONS: PARCEL NUMBER/S 2. Env. Health SEPA Planning Mobile Home OWNER) Fire Marshall Co. Engineer Other(Specify) PHONE Utilities 3 TOTAL $ Zone Clearance IN THIS SPACE, WHEN MACHINE VALIDATED SEPA Checklist THIS BECOMES A PERMIT. ADORE DATE=( OFFICIAL ZIP Required Set Backs in Feet North South East West CQWRPCT0R PHONE Size of Parcel Zone Classification Q� 4. A RESSZ Type Const. Sprinklered 0zh ��C)1 TOccupancy ❑Yes ❑No ❑ Req'd. D SIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP DWL Area Basement Area Garage Ar;aT Storage CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. No. Baths No. Floors i No. Rooms Rec. Room, TYPE NEW ❑ ALT. D'N. ❑ RPL. ❑ MVE. 7, OF if ❑ OTHER D. ❑ PLMB. E)MECH: ElM.H. El POOL CERTIFICATE Req'd. Recd. Not Req'd. WORK of EXEMPTION DES IBE WO K FEES COLLECTED 8 PERMIT IVUMBER M -- ►try DATE 04* *9.00 *9.00U E 1 64,7 02-28-80 A 6479, VALUATION Source GAS ELECTRX WATER SEWER of 9, utilities 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. Plumbing 1a) SIGNATURE ` DATE -PIZ Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. RECD. Plan Check Env. Health SEPA Planning Mobile Home Fire Marshall Co. Engineer Other(Specify) Utilities TOTAL $ Zone Clearance IN THIS SPACE, WHEN MACHINE VALIDATED SEPA Checklist THIS BECOMES A PERMIT. DATE=( OFFICIAL APPROVED FOR ISSUANCE - 1. rr 0 I— cU — w ri z