1980, 11-17 Permit P80B-3836 SoftenerAPPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456.3675
APPLICANT: COMPLETE NUMBERED SPACES--.PRESc HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
BLOCK
/ / c La Ai &it-41 A)
SUBDIVISION
3.
4.
OWNE
ADDRESS
/ NA) /' / n-+ fa/ .
..4) ,J/()
CONTRlI(CTOR
PHONE
dc�•/fit
ZIP9
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South East 'West
Size of Parcel Zone Classification
ADD
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Type Const. Occupancy
Valuation
Main Floor
Upper Floors
Area of Decks
Sprinklered
DYes ❑No 0 Req'd.
Building Area In Sq. Ft.
Garage Area
Storage
Finished Basement Unfin. Basement
TYPE
7, OF
WORK
❑ NEW ❑ ALT.J0 AD N. 0 RPL. ❑ MVE.
❑ BLD.LMB. 0 MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths 1 No. Stories
No. Rooms INo. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECT R I
WATER
SEWER
Enum. Dist. 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
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Not Req'd.
FEES COLLECTED
Single
Building
Ud
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
$
TOTAL $
PERMIT NUMBER
03'* *3.00
*3.00 5
*3.00�
A *0.00
383.52
11-17-80
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• ,I
1,11 17 p31816 *3,00?,1=1 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED
PERMIT NO.
TOTAL