1979, 12-14 Permit: 79-9090 Water SoftenerPLP -SI NU.VIBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
3.
4.
JOB ADDRESS
LOT
OWNER
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
BLOCK
ADDRESS //-- �
LI –IMO ( C
CONTRACTLTR
4/lJ r l..i t _;J l' i i / Y c9
S DIN
ADORES
DESIGNER
5.
ADDRESS
6.
l.Ocdcti
u�n�ic9
CHANGE OF USE FROM
TYPE
7, OF
WORK
9.
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
DESCRIBE WORK caL
VALUATION
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East (West
Zone Classification
Size of Parcel
Type Const.
Valuation
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
DWL Area I Basement Area
Split Entry
No. Baths
Q / & &Jt.
Source
of
Utilities
GAS
ELECTRIC
Garage Area
Split Level
No. Floors
No. Rooms
CERTIFICATE
of EXEMPTION
Req'd.
Storage
Rancher
Rec. Room
Rec'd.
Not Req'd.
WATER
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
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
_ OFFICIAL
APPROVED FOR ISSUANCE
41
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 3 c
p
PERMIT NUMBER
-7a-aocjo
DATE
03* *300
* 300
* 3,006
E *0.00 0
90&92
12-14-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS,B�COIi(IE,S��F�MIT.
909.08 *3.00a�