1980, 02-28 Permit: 80-1642 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 4 COPIES
JOB ADDRESS /
LOT BLOC SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
3.
OWNER
ADDRESS
C�7R62 ""Z ` 1/
CONT
4 s,C�� _ eS
C
' ADD
6.
DESIGNER
ADDRESS
CHANGE OF USE FROM
TO
P,410NE
PHONE
`I1 7 6)
PHONE
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
TYPE
7. OF
WORK
9.
❑ NEW ❑ ALT. ❑ AD'N.
9 BLD. /� PLMB. 0 MECH.
DESCRIBE WORK
VALUATION
xqurce
of
Utilities
❑ RPL. ❑ MVE.
❑ M.H. ❑ POOL
GAS
0 OTHER
DWL Area I Basement Area Garage Area
Split Entry
No. Baths
WATER
Split Level
Storage
Rancher
No. Floors No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
SEWER
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.
DATE
SIGNATURE
Req'd.
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE PI 5 OFFICIAL +\C1.A.A."
APPROVED FOR ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
(PERMIT NUMBER
i0-1(01-0. I
DATE
04* *3.00
*3.00M
E *0.00 0
164.1
02-28-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 '2 '- 2 $;c- $ '0• 16 11 2 2