1981, 08-19 Permit: 81A-8287 Heat PumpPLAN NUMBER APPLICATION/ PERMIT // PERMIT NUMBER
4 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 t(L LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK ISUBDIVISION I PARCEL NUMBER/S
WNER;
P},1,ONE
3.
`�
ADDR S
ZIP (
Actual Set Backs in Feet
�' ...-
/ 1�j1 `F,, '
North South
Last West
COryJ-RjRA
PHONE
Size of Parcel
Zone Classification
I=
4. ADD ESS
ZIR.Type
Const.
Occupancy
Sprinklered
'0"
I
Dyes ❑No 11 Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
�J.
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 1:1 NEW ❑ALT. ElAD'N. El RPL. 1-1MVE.
7, OF \,/ ❑ OTHER
El BLD. 11PLMB. b(! MECH. ❑ M.H. El POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
� \
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
FEES COLLECTED
8
VALUAION
SOU E
GAS
EL CT C
W TER SEWER
Ownership
USE CODE
9.
UTIITIES
Public ❑Private ❑
Single $
1 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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
-
Mech.
DATE OF APPLICATION���'�% SIGNATURE OF APPLICANT
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Co. Engineer
ns Examiner
nician PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify)
TOTA L $'
04 * 1 4,00
*1k00
* 1 4.001
A *a00
828.62
08-19-81
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED PERMIT NO.
a+
Y
*14,00Q�
TOTAL
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