1981, 01-30 Permit M81A-1034 Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
I%
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
S ) C2c(s }-ea
LOT
BLOCK
SUBDIVISION
3
OWNER
ADDRESS
Lynn, LarSon
S Nas Pel*
CONTRACTOR
4. 5-1-it tV---)
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
gab— 3i1,8
ZIP
PHONE
9a0
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER'S
Actual Set Backs in Feet
North
South East
Size of Parcel
Type Const. Occupancy
Valuation
Main Floor
West
Sprinklered
❑Yes ❑No ❑ Req'd_
Building Area in Sq. Ft.
Area of Decks
Finished Basement Unfin. Basement
TYPE
7. OF
WORK
8.
9.
IJ NEW 0 ALT. 0/Ap N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. IU MECH. 0 M.H. ❑ POOL
DESCRIBE WORK
ns�tfl
VALUATION SOURCE
OF
UTILITIES
hrler
GAS
ELECTRIC
X—C
WATER
0 OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private ❑
Location (Area)
Req'd. Rec'd.
USE CODE
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
DATE OF APPLICATION 1 —'S— 2 t SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
/; cz'
04* *14,00
*1400
* 1 4,006
A *0,00
103,32
01-30-81.,
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
lding
c nician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
01;y31!
DATE ISSUED
101'4 g * 14 0 ,0.10
PERMIT NO.
TOTAL