1981, 09-08 Permit: 81A-9019 Water SoftenerJIBER
PLAT`
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
JOB ADDRESS
cid
LOT BL KI SUBDIVISION
OWNER
3 ��14\b,
AD R S ,)C��'7`0`1:
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CONT � f J1" /Q —
4.
5.
ADDRESS
DESIGNER
7331.
455 -- So 50
ZIP
ADDRESS
CHANGE OF USE FROM
TYPE
7. OF
WORK
PHONE
ZI P
TO
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
D BLD. 0"PLMB. ❑ MECH. 0 M.H. 0 POOL
❑ OTHER
DESC I E WORK
VALUATION
9.
SOURCE GAS ELECTRIC
OF
UTILITIES
WATER
SEWER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North
South East
Size of Parcel
Type Const.
Valuation
Main Floor
Occupancy
Upper Floors
Area of Decks
No. Baths
West
Zone Classification
Sprinklered
❑Yes No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement Unfin. Basement
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Ownership
Public ❑ 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. SE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SP CIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
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 $
00
�
PERMIT
5IX— NUMBER
c1i
f
3* *500
*5.00 V)
*5,006
A *0.00
901.82
09-08-81
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
bg'. re's 8'1
DATE ISSUED
90192
PERMIT NO.
*5Q0a°FJ
TOTAL