1980, 10-14 Permit: 80B-1957 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
1: c . i X005 /&34 nc!t
LEGAL DESCRIPTION — SEE ATTACHED
- LOT
BLOCK
SUBDIVISION
2.
ChtnER
3 J r41..04.Z.44 a, 6UCLeww
ADDRESS p
i A/ot5 /,T deivr/?r
ONT ACTOR
4.LLGC f/ CG:
AD RESS
n.
2,'r�ni
DESIGNER
5. ADDRESS
PARCEL NUMBER/S
PHONE
ZIP
992/4
Actual Set Backs In Feet
North 'South (East 'West
PHONE
5 O0.TO
Size of Parcel 1 Zone Classification
•ZIP
99.202
Type Const.
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
PHONE
Valuation I Building Area In Sq. Ft.
ZIP
Main Floor
Upper Floors l Garage Area
Storage
CHANGE OF US'. FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
O NEW
O BLD.Dif
❑ ALT.
PLMB.
O AD N.
❑ MECH.
O RPL.
o M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. o Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
SCRIBE WO.R> CPL 4c/q,)
�,Pyfi//IySOURCE
OF
9. /UTILITIES
GAS
ELECT IC
WATER
SEWER
Enum. Dist.
Location (Area)
Ownership
Public D 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 10'�'�i'—�U
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
▪ ldi r T hnic'sin
./ 4
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
/ d
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 3�
aIPERMIT NUMBER
03* *300
*30.0 l
*3006
A *000 6
19562
10-14—SO
2 6479. '
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
195:? Z
PERMIT NO.
03`00,2 --
TOTAL
LL.