1980, 02-11 Permit: 80-1054 Water SoftenerPLAN NUMBER
APPLICATION/ PERMIT
PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
_
APPLICANT: COMPLETE NUMBERED SPACES — PRESC HARD TO MAKE 4 COPIES
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JOB A DRESS r
LEGAL DESCRIPTION — SEE ATTACHED
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t: 4;
L OT
BLOCK
SUB VI ION
PARCEL NUMBER/S
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QWN �
PHONE,F
3.
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ADD ESS
ZIcP- n
Required Set Backs in Feet
`�
North South East West
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CONTR TOR
PHONE
Size of Parcel
Zone Classification
4' ADDRESS
ZIP
Type Con,t.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
o
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE ❑NEW 1:1 ALT. 1-1AD'N. El RPL. 1-1MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
%, OF
WORK 1:1 BD. PLMB. MECH: ❑ M.H.
OTHER
POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
of EXEMPTION
DESCRIBE WORK � ' FEES COLLECTED
_ s �
8
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9.
of
Utilities
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 Building
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,
Plumbing
DATE
SIGNATURE _ Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
i
Co. Engineer
Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
DATE OFFICIAL-