1980, 12-04 Permit: 80B-4455 Water Softener'LAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
APPLICANT: COMPLETNUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
O�
u6 f
LEGAL DESCRIPTION — SEE ATTACHED
LOT
OWNE
BLOCK
SUBDIVISION
ADDRES
CONTRA
ee
AD 7,0 a 70 7
} 4/' («9
ZI^9 s
PHONE
//
V
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
Size
Size of Parcel
Type Const.
Occupancy
East
(West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
I.
TYPE
OF
WORK
4 NEW
0 BLD.
N ALT. 0 AD'N.
--k PLMB. 0 MECH.
DESCRIBE WORMet
VALUATION
SOURCE
OF
UTILITIES
GAS
❑ RPL.
0 MVE.
❑ M.H. 0 POOL
EL TRIC "I WATER
0 OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownership
Public 0 Private 0
USE CODE
Req'd.
hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
)n reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
:ype of work will be complied with whether specified herein or not. The granting of a permit does not presume
:o give authority to violate or cancel the provisions of any other state or local lawegulating construction or the
)erformance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION !��� SIGNATURE OF APPLICANT t;� �6L `^���jC�
SPECIAL APPROVALS
NAME DATE
Env. Health
Tanning
=ire Marshall
Co. Engineer
Jtilities
glans Examiner
TEPA Checklist
Building Technician
CY ON 1
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
3°P
Cid
TOTAL $
prifRMIT NUMBER
ecB* 44 "S
*
*
0
/>_ 5 /I,
i;4- 8 v
6 4 79
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12-04 tO 40.5g *3.1008.'1:1.-
-t-