1984, 01-19 Permit: 84A-566 Water SoftenerPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
STREET ADDRESS
S. 2121 Conklin Rd.
Veradale, WA
LOT
2.
BLOCK
SUBDIVISION
3
OWNER
Charles Furniss
MAILING ADDRESS
Same
PHO E
928-6698
4.
CONTRACTOR
Soft Water Service Co.
ADDRESS
E. 25 Third Ave.
LICENSE EXPIRES
PHONE
ZIP
99037
P455 8050
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North
Size of Parcel
South
East
West
Zone Classification
ZIP
99207
Type Const. I Occupancy
Residential ❑
Commercial El
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
TO
TYPE CJ NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
New Const. Valuation
Remodeled Valuation Total Bldg. Floor Area
Main Floor 'Upper Floors I Garage/Storage
Cover Deck
Uncv. Deck
Greenhouse
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No
Received Yes No
Number
8.
DESCRIBE WORK
Water Softener
Shorelines/Flood Hazard Plans Required ❑
Yes ❑ NotApplic. ❑ Received ❑
VALUATION
9.
SOURCE
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC El
SEWER El
Ownership
Public El Private ❑
1 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 au-
thority 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
SIGNATURE OF APPLICATION
Soft Water Service Co.
OWNER OR AGEN~ DATE 12J12/83
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
/Al
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS i D '411..9 — 8 /� PERMIT N . U. 1 Z * )' 0 O :tie'
tAL
DATE `t
FEES COLLECTED
Building
•r
Plumbing
?r, i
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
U>✓
TOTAL $
PERMIT NUMBER
*500
*5.006
R *0.00 8
5652
01-19-84
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.