1981, 05-18 Permit: 81A-4805 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
JOB ADDRESS/
ACL
LOT
BLOCK SUBDIVISION
OWNER
3 l
4.
F HONE
PARCEL NUMBER/S
co
ADDRESS
/(//,y3
CONTRACT
ADDRM
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
.54' NEW
❑ BLD.
LEGAL DESCRIPTION — SEE ATTACHED
Zl�c-26�J
PHONE . f,/c37C,
Wi•l,,J7/)
PHONE
ZI P
TO
❑ ALT. ❑ AD'N.
,(jPLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
Main Floor 1 Upper Floors Garage Area
Storage
Area of Decks
Finished Basement Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
VALUATION
9.
r (�) zt
GAS ELECTRIC
SOURCE
OF
UTILITIES
c1�
SEWER
CERTIFICATE
of EXEMPTION
Enum. Dist. 'Location (Area)
Ownership
Public 0 Private 0
Req'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 locaL1aw regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPEC IINS
DATE OF APPLICATION
37-7/f/
SIGNATURE OF APPLIC d-€ttL
SPECIAL APPROVALS I SPECIAL 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
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
`LM ch.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
6/19 '/8'o 5-
03*
03* *500
*500
*5006
A *0.00
480,4
05-18-81
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
015;)7.1 8
DATE ISSUED
480.52 *5.00 RI
PERMIT NO. TOTAL