1980, 04-16 Permit: 80-3549 Water SoftnerPLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
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.,
LEGAL DESCRIPTION — SEE ATTACHED
LOT B O K ISDIVISION APARCEL NUMBER/S
2.
OWNER PHONE
3.
ADDRESS
ZIP
Actual Set Backs in Feet
North South
East West
ONTRCTOR
PHONE
Size of Parcel
Zone Classification
4'
AD SS
ZIP
TypeConst.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
o
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
Baths
No. Stories
No. Rooms
No, of Dwellir
TYPENo.
NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% OF ElOTHER
� I
❑BLD. � PLMB. 11MECH. ElM.H. ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'
WORK
of EXEMPTION
DESC IBE WORK
Enum. Dist.
Location (Area)
`
8.
FEES COLLECTED
VALUATION SOURCE
S
1
ELECTRIC
TER SEWER
Ownership
USE CODE
F
9. UTILOITIES
Public ❑Private ❑
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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
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
Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
co. Engineer
Utilities
Plans Examiner jl
n
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
03* *3.GC
*30C s
*3.00
E * O
354,8
04-�6-ao
�- 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.