1984, 01-30 Permit: 84A-806 Water SoftenerUnfin. Basement
PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
STREEAT DDR'�``/,�
LOT BLOCK SUBDIVISION
2.
3.
4.
OWNER,
)� 7N•
MAILING ADCRESS
CONTRAp6R
PHON5.1
LICE SE EXPIRES,
PARCEL NO.
ONE
ZIP
ADDRESS
•
DESIGNER
3`2()-7
ZIP�-
6z72-
ADDRESS
CHANGE OF USE FROM
T
PHONE
ZIP
TYPE ❑ NEW
7. OF
WORK ❑ BLD.
DESCRIBE WORK
VALUATION
9.
❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER
SOURCE
UTILITIES
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North ,South
Size of Parcel
Type Const.
East
West
Zone Classification
Residential D
Commercial ❑
Occupancy Spr'nklered
❑Yes El No ❑Req'd.
New Const. Valuation
Main Floor
Cover Deck
No. Baths
Certif1. of Exempt.
or Variance
Remodeled Valuation
Total Bldg. Floor Area
Garage/Storage
No. Floors
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes C No
Received Yes Noll
Shorelines/Flood Hazard
Yes❑ Not Applic. D
Ownership
Public ❑ Private ❑
1 hereby certify that 1 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 au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REV - SES SIDE FOR RE • IRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE
SP CIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
No. Dwellings
Number
Plans
Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing —
Mech.
Plan Check
SEPA
Modular/
MFG. Horne
Other (Specify)
TOTAL $
PERMIT NUMBER
A
*500
* 5.006
* 0,00
80.52
01-30-84
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ra
DATEisiu-ir 0 - —8 4
PERMIT N8.0, 6 z
*500aQ�AL