1980, 09-29 Permit M80B-1094 Heat PumpPLAN NUMBER
(C y
APPLICATION/PERMIT
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
• 2
EAT O4 OCK SUBDIVISION s)
2.
OWNER
3. (•=fte RoT1i
ADDRES
. i D kk & i-= Eek E T D K'
CONTRACTOR
4. M - / i-IEf1TL PJ& R, Ji/e)CO�
ADDRESS LE
DES GNER
PHONE
PHONE
it-kl-e/SV
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
Size of Parcel
Type Const.
Valuation
Occupancy
!East
Zone Classification
(West
Sprinklered
❑Yes ENo ❑ Req'd.
Building Area in Sq. Ft.
5' ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
6.
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
fit NEW
❑ BLD.
O ALT.
❑ PLMB.
❑ AD'N.
14 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
El POOL
DESCRIBE WORK
8. I (JSTu HEt 1 i Pt.1 VIP 0 'DueT ',,JOleK
WATER
VALUATION
9
454
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 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 SIGNATURE OF APPLICANT
0 OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. 'Location (Area)
USE CODE
SOURCE GAS I ELECTRIC
OF
UTILITIES
Ownership
Public ❑ Private ❑
Req'd.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ e?. CO
M
PERMIT NUMBER
2Es- -109cr
*9.00
*9,00
*9,006
A *0.00
109.32
09-29-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist
ian S'
PERMIT IS NONTRANSFERABLE
9L2'9'-8 0
109.4
*9,00°1 -
DCD11111T I YPII5FR (IMF YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL