1979, 10-01 Permit: 79-5005 Water SoftenerPLAN NUMBER APPLICATIOWPERMIT
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
1. EVERGREEN ROAD, N. 5105 LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNER MICHAEL POULIN
�. ADDRESS
SAME
CONTRACTOR
LINDSAY SOFT WATER OF SPOKANE
4. ADDRESS
E. 728 SPRAGUE
DESIGNER
U.
ADDRESS
CHANGE OF USE FROM ITO
6.
PHONE
924-2577
ZIP
PHONE
624-1243
ZIP
PHONE
ZIP
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% OF WORK ❑ BLD. %S PLMB. ❑ MECH: ❑ M.H. ❑ POOL ❑OTHER
DESCRIBE WORK
ize of Parcel
Zone Classification
VALUATION Source GAS ELECTRIC WATER SEWER
Type Const.
Occupancy
Sprinklered
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
❑Yes ❑No ❑ Req'd.
'aluation
Building Area in Sq. Ft.
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
DWL Area
Basement Area
Garage Area
Storage
DATE SIGNATURE _
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
Split Entry
Split Level
Rancher
Env. Health
SEPA
No. Baths
No. Floors
No. Rooms
Rec. Room
Fire Marshall
Co. Engineer
Other (Specify)
CERTIFICATE
Req'd.
I Rec'd.
Not Re(
of EXEMPTION
WHEN MACHINE VALIDAT
8. WATER SOFTENER
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9, Utilities
Single $
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
Building
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
3.00
performAce of construction.
Plumbing
DATE SIGNATURE _
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
3.00
TOTAL $
Zone Clearance
WHEN MACHINE VALIDAT
SEPA Checklist _
DATE OFFICI
7PE(�RMIT.
THISBECOMESA7,9
1 U — 0 1 — ,
/
7
PERMIT NUMBER
1,31
DATE October 1, 1979
03* *3.00
*3,00
*3.00
B *GOO
500.42
10-01 -79
2 6479.
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