1980, 03-07 Permit: 80-1891 Water SoftenerPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT_
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (5091 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK TSUBD VISION
PARCEL NUMBER/S
OWNER
3 %%7ur�
ADDRE y
CONTR TOR
4. N�db(—S— /
ADD C ;)67 �l
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
1)AJ
'%O%
PHONE,
9a y 6502Xz
ZI PC .
PHONE
/i 71)
PHONE
ZIP
Required Set Backs in Feet
North 'South East ''West
Size of Parcel - Zone Classification
Type Const. Occupancy Sprinklered
❑Ves ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
DWL Area Basement Area ` Garage Area Storage
TO
Split Entry
Split Level
Rancher
®NEW
0 BLD.
DESCRIBE WORK
8.
VALUATION
9.
El ALT. 0 AD N. 0 RPL. - ❑ MVE.
L PLMB. ❑ MECH: ❑
altirc
Source
of
Utilities
0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
GAS
E E RIC
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:
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
3o&
.366
TOTAL $
PERMIT NUMBER
p sso 14Q
DATE
03* *300
*300 b
*3006
E *000 3
189.0
03.--:07=80
2 6.479.
• WHEN MACHINE VALIDATED IN THIS SPACE,
THISBECOMESA PERMIT.
DATES D—%p7� OFFICIAL `+5' ,0,�._8rO1 18.915 *30.,O,2�
APPROVED FOR ISSUANCE -