1979, 09-20 Permit: 79-4396 Water SoftenerIPLAN 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
1./-0 2'(;:t/c.‘-ki E.. /V/5'
2.
3
4.
JOB ADDRESS
.„,,,,2
LOT
BLOCK
SUBmVISION
LEGAL DESCRIPTION — SEE ATTACHED
CONTRACT.R
I. - �l.[Je,-42.-)
ADDR • +-
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
8.
TO
PHONE
av9aa7
ZIQ..9„\.e6
PH /
ONE
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South [East 'West
Size of Parcel 1 Zone Classification
PHONE
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
❑ NEW
❑ BLD.
DESCRIBE WORK
❑ ALT. D AD'N. ❑ RPL. ❑ MVE.
APLMB. 0 MECH: 0 M.H. ❑ POOL
VALUATION
9.
Source
of
Utilities
GAS
0 OTHER
Valuation 1Building Area in Sq. Ft.
DWL Area
Split Entry
No. Baths
Basement Area 1 Garage Area Storage
Split Level
No. Floors
Rancher
No. Rooms Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
ELECTRIC
WATER
SEWER
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
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
7.0
FFICI
APPRO 1 FOR ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
DATE
PERMIT NUMBER
—x'39,
/979
03* *3.00
*3.00 N
*3006
E *Q00 8
439,58
09-20-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
091,_;,20 7'9 43'9.62 *3,00a�