1981, 04-30 Permit: 81A-4142 Water SoftenerPLAN NUMBER
APPLICt1":.,N/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 /PDDREaSS
1.
2.
3. OWNED(%'�/, '
ADfRFSS / '-Z11/// 4 et '6
LOT
„r,,tr- .
pLOc SUBDIVISION �,
LEGAL DESCRIPTION - SEE ATTACHED
CONTRACTOR
4'
ADD E S / +
2.17
DESIGNER V
5.
PHONE
?g -s75 -,z
O
ZIP
�lv-Y�
PARCEL NUMBER/S
Actual Set Backs in Feet
North !South
'East
'West
PHONE
Size of Parcel I Zone Classification
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZI P
Main Floor Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
LJ NEW ❑ ALT. ❑ AD'N.
PLMB. ❑ MECH.
❑ BLD.
❑ RPL. D MVE.
❑ OTHER
❑ M.H. ❑ POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DERIBE WORK
VALteK
UATIlO>
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public ❑ Private ❑
Location (Area)
USE CODE
I hereby certify that I have read aria 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 PECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
r
✓D
PERMIT NUMBER
03* *500
*5.00 Vi
*5.00'6
A *0.00 8
414,12
04-30-8.1
z 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 4--.10;7,11.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
414, 2 z
*5.0
0 °a -