1980, 11-04 Permit: 80B-3163 Water SoftenerPLAN NUMBER
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--O-r';�v�l
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
ADDR
CONTR TOR
AD E S ,� Lf -1
Z.4 C36/L)
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
NE
dGY[J
ZIP
Jo2Ci�
PHONE 4)7
"4/44(;%'.-7/ ?c
PHONE
ZIP
TO
❑ ALT. ❑ AD'N.
LMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
PARCEL NUMBER/S
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
ELECTRIC
SEWER
Main Floor
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
East
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Unfin. Basement
No. Rooms
Location (Area)
Ownership
Public ❑ Private 0
USE CODE
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 /1-3 -Fd
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Build,iinngTTecchni an10 ,' J
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
03* • *3.00
*300
*3006
A *0.00
3162
11-04-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11_ a .7'8 p. 316.3 z
DATE ISSUED PERMIT NO.
*10.0a1—
TOTAL