1979, 08-03 Permit: P79-1504 Water SoftnerPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LOT
2.
BLOCK
SUBDIVISION L C� /
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNER
3.
ADDRE
PHONE
30ts—
5. ADDRESS
ZI P
PHONE _
ZIP
79,2-e
PHONE
Required Set Backs in Feet
North 'South East 'West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
Oyes ❑No 0 Req'd.
Valuation Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
Split Entry
Split Level
Rancher
O NEW
❑ BLD.
❑ ALT.
1` PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
FEES COLLECTED
Single $
Building
Plumbing `3u�
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
�? 15=91 --
DATE
'(—
DATE Cl3 oZ/ �t0r
3'' �0 �
*300 t
*300v
A *000 S
15032
08-03-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISdrOn A
150.45 *3.0.0°
INCPFrrnR