1982, 12-29 Permit: 82B-2343 Water SoftenerPLAN NUMBER
No. Baths
No. Floors
APPL IiCAT ION /PERMIT PERMIT NUMBER
No. Dwellings
El ALT. El AD' N. El RPL. 13 MVE.
7 ❑ OTHER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY e�;� t5
Certifi. of Exempt.
Required Yes❑ No❑
Number
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
or Variance
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
ST Er ADDRESS
Shorelines/ Flood Hazard
PAF�6ft NO.
�j
Received ❑
VALUATION
SOURCE
OF
LOT
BLOCK
SUBDIVISION
I SEWAGE
❑
Ownership
LEGAL DESCRIPTION:
FEES COLLECTED
2.
I
PRIVATE ❑
SEWER ❑
public ❑Private ElUTILITIES
OWNER
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
PHONE
P ON
3OZ
Building
f;"I
u
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
�.
Plumbing
SIGNATURE OF APPLICATIONI�
MAILING ADDRESS
OWNER OR AGENT DATE r
ZIP
Actual Set Backs in Feet to:
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
�C5
North South East West
Env. Health
CO TRACTOR
LICENSE EXPIRES
HONE
Size of Parcel
Zone Classification
Residential
!�
Modular/
Commercial ❑
4.
MFG. Home
Fi re
Prevent.
ADDRESSZIP
Type Const.
Occupancy
Sprinklered
Other (Specify)
1
i
2--
❑Yes El No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement
6.
TOF YPE �EW
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
El ALT. El AD' N. El RPL. 13 MVE.
7 ❑ OTHER
Certifi. of Exempt.
Required Yes❑ No❑
Number
WORK 1:1BLD. S PLMB. ElMECH. 11M.H. ❑ POOL
or Variance
Received Yes❑ No❑
DESCRIBE W RK
8•
Shorelines/ Flood Hazard
Plans Required ❑
Yes Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC El
I SEWAGE
❑
Ownership
FEES COLLECTED
9
I
PRIVATE ❑
SEWER ❑
public ❑Private ElUTILITIES
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
Building
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority 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
SIGNATURE OF APPLICATIONI�
OWNER OR AGENT DATE r
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fi re
Prevent.
Other (Specify)
Pnn;nm
i
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
7ATIJItLEI� 9_ 1 2 PERM172Nd.4 5 z
* 5. 0 0 OTo!JAL
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