1982, 10-01 Permit App: 82A-9197 SoftenerPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
3.
LOT
ADDR
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
BLOCK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OW SFR
Ap4RESS�h��
nc�
CONT ACTOR
Lf .72
a. ESJ3 3-76)
PHONE
4'?/it
ZIP /
P f1 —4;Size of Parcel
Actual Set Backs in Feet
North !South
Type Const.
Occupancy
'East West
Zone Classification
Sprinklered
Oyes No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW ❑,, ALT. 0 AD'N. 0 RPL. 0 MVE.
0 BLD. LFPLMB. 0 MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
eq'd.
Rec'd. Not Req'd.
DESCRIBE WK
8.
3E
Enum. Dist. I Location (Area)
9.
VALUATION SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
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. AH provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. Th::ranting of a permit does not presume
to give authority to violate or cancel the provisions of any other state o ocal law reg ))ting construction or the
performance of construction SE�E/REVERSE SIDE FOR REQUIRED IN ,'ECTIONS
DATE OF APPLICATION /lJ SIGNATURE OF A
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $c(7t
PERMIT NUMBER
6,A(7'7
03* *500
*5006
A *000
919.62
10-07-82
2 6479. -
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-07-82 919,75 *50020 -
DATE ISSUED
PERMIT NO. TOTAL