1980, 06-03 Permit: 80-5299 Water SoftenerPLAN 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 3 COPIES
JOB ADDRESS
LOT
BLOCK
3.
OWNER
SUBDIVISION
ADDRESS
z kcy-1 ktkrYlakk
,E..
PHONE
ZIP
Ct.Qca
4.
CONTRA TOR
PHONE
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
NEW
0 BLD.
❑ ALT.
PLMB.
ZI P
•
•_
PHONE
ZI P
TO
O AD'N.
O MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North South East West
Size of Parcel
Type Const.
Occupancy
Valuation
Main Floor
Upper Floors
Zone Classification
Sprinklered
❑Yes ❑No D Req'd.
Building Area in Sq. Ft.
Garage Area
Area of Decks
Finished Basement
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
Storage
Unfin. Basement
No. Rooms
Req'd.
DESCRIBE WORK
9.
VA UATION SOURCE
OF
UTILITIES
GAS
IN►1-C ..1 t
ELECTRIC
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private 0
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Ing
Te
hn
clan
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
lumbing
Mech.
Asn
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
- ` PERMIT'at/m[3ER
03* *3.00
*3,00 tsi
*3.006
E *0.00
529.8
06-03-80
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0-6'40 3;'=8.0
29,92
DATE ISSUED PERMIT NO.
*3.00a.
TOTAL