1981, 02-18 Permit: 81A-1616 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
1.
2.
3
JOB ADDRESS
i73 . 714 1.11.i11011e-
LOT
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
OWNER
�ti17 rtii7^ �R] '1—IIEL
PHONE
PARCEL NUMBER /S
ADDRESS
ZIP
Actual Set Backs in Feet
North !South
East
IWest
4.
CONTRACTOR
`_%PT L..ki4Tr fiL.
PHONE
Size of Parcel
Zone Classification
ADDRESS
^� r' 7) 12-P
Y i
ZIP
Crki
Type Const.
Occupancy
Sprinklered
01 Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
LI NEW ❑ ALT.
❑ BLD.PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8. 111 %!Fir
VALUATION
9.
SOURCE
OF
UTILITIES
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
GAS
ELECTRIC
WATER
SEWER
Ownership
Public El Private ❑
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
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 $ 6
PERMIT NUMBER
03* *5.00
*500
*5.006
A *000 8
161.52
02 -18 -81
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'2p -1i 8' 181'
DATE ISSUED
16162 *5000_. -
PERMIT NO.