1980, 03-11 Permit: 80-2092 Water Softener 13LAN NUMBER APPLICATION/PERMIT PERMITg�NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT FJ`" - 2'
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
{ it * * 3, 00+
JOB ADDRESS
1 ' 7 - 3067 K100014NAIki R 1 LEGAL DESCRIPTION - SEE ATTACHED * t" `;
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 3 C 0
2. OWNER P w ( l 4- C i 1,
3 ADD ESS j.1J� I /�[„/ Required Set Backs in Feet G U �
. • 3O o7 W 00�I, NI f North (South East (West
CONCTO,q PHONE Size of Parcel Zone Classification 0 - ' 1 -8 0
Mll%/ 6,479,
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area I Basement Area Garage Area Storage —
s
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6. •
�/ No.Baths No. Floors No. Rooms Rec. Room
TYPE
R� NEW ❑ A�T. ❑ AD'N. ❑ RPL. ❑ MVE.
], OF �/ ElOTHER
,
WORK ❑ BLD. LMB. MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCFJIBE W RK
8. IYAVIcf- FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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 O
to give authority to violate or cancel the provisions of any other state or local layv regulating construction or the Plumbing
performance/of c nstruction. ;/
DATE 3 1 6 SIGNATURE- -. .1 _ Mech.
j
SPECIAL APPROVALS SPLA COIo IONS:
DEPT. REQ'D. RECD. /J !� Plan Check
Env.Health i .-v
SEPA <_)
Planning _ ;ii
n
Mobile Home y)
Fire Marshall
Co. Engineer
Other (Specify) '
Utilities e
TOTAL $S
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist —1 THIS BECOMES A PERMIT.
ya, / . .illik -r 0 3.—;l l+—B.`rl. 9. % * (c?.
DATE OFF �_ :_ U �. U
NO Li
A"ROV 1 •R ISSUANCE _