1980, 02-01 Permit: 80-1052 Water SoftenerPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
/ �
CERTIFICATE
LEGAL DESCRIPTION — SEE ATTACHED
1
Req'd.
G
Not Req'd.
WORK
of EXEMPTION
LOT
BLOCK
SUBDIVISION
DESCRIBE WORK
8 ��
FEES COLLECTED
PARCEL NUMBER/S
2.
VALUATION
I
GAS
ECTRIC
WATER
SEWER
OWNER
�f�
P ONE
I
3.
2 i' .
Single $
%�e
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
ADDRESS
���
{
ZIP//��
V��(C/
Required Set Backs in Feet
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
/
performance of construction.
Plumbing
North South East West
Mech.
CONTRACT
SPECIAL CONDITIONS:
PHO
Size of Parcel
Zone Classification
Plan Check
Env. Health
4'
Planning
Fire Marshall
Mobile Home
Co. Engineer
ADDR �
Other (Specify)
ZIP 7C 1
!V1
Type Const.
Occupancy
Sprinklered
,
Zone Clearance
/G/G�'
[]Yes ❑No ❑ Req'd.
WHEN MACHINE VALIDAI
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
DATE OFFICIAL
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No.
Floors
No Rooms
Rec Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
❑ BLD. AfPLMB. ❑ MECH: ❑ M.H. ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
8 ��
FEES COLLECTED
��e�
VALUATION
Source
GAS
ECTRIC
WATER
SEWER
9.
of
1 Utilities
I
I
I
Single $
1 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 presumeaQ
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
Plumbing
DATE SIGNATURE _
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
4110
TOTAL $_
Zone Clearance
WHEN MACHINE VALIDAI
SEPA Checklist
THIS BECOMES A PERMIT.
l(
-SD O
.,�_���
DATE OFFICIAL
PERMIT NUMBER
A -P b
DATE
C )
105'1
02-1 1 - 0
6.1179
IS SPACE,
J11-