1981, 05-15 Permit: 81A-4789 Water SoftenerPLAN NUMBER
APPLICATION/ ,'ERMIT
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 SUBDIVISION
OWNE
3
ADDRESS
CONTRACTOR
4' ADD S
PHONE
ZI P
9019,
P4NE
E
.._r---;
DESIGNER
5. ADDRESS
I R(%)
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
TO
NEW,❑,/LT. ❑ AD'N. ❑ RPL. ❑ MVE.
El BLD. rJ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
El OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North
South Eas
Size of Parcel
Type Const. Occupancy
Wes
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
Building Area in Sq. Ft.
Garage Area
Finished Basemen
Storage
DESCRI E WORK
VALUATION
9.
GAS
ELECTRIC
WATER
SEWER
No. Baths No. Stories No. Rooms
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. of Dwellings
Location (Area)
Ownership
Public ❑ Private 0
Req'd. Rec'd.
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
doimeimmak
SPECIAL APPROVALS
NAME DATE
SIGNATURE OF APPLICANT
ok
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ng Te n f
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
*7&7
03* *500
*5.00
*5,006
A *000
478.82
05-15-81
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
15;!-1' 5' - B `l' 4 7 8.9 z
DATE ISSUED
PERMIT NO.
# o -Oar
TOTAL