1981, 06-09 Permit: 81A-5640 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
LOT
2.
BLOCK
I62Qc .5. TRLL�2 0./u
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
'M&& C
ADDRES
4,c)c2
CONT ACTOR
4.
(3a:�'7o7
PHONE
:5'S �9ass
Zia),
PHONE E�/xfone_
/J29 -z'70
5.
DESIGNER
;C/,;.`tin
PHONE
ADDRESS
ZIP
Actual Set Backs in Feet '
North (South East (West
Zone Classification
Occupancy Sprinklered
❑Ves ONo 0 Req'd.
Building Area In Sq. Ft.
Upper Floors Garage Area Storage
Size of Parcel
Type Const.
Valuation
Main Floor
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE 'AINEW
7. OF
WORK 0 BLD.
0 ALT. 0 AD N. 0 RPL. 0 MVE.
_PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE
8.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELE T
WATER
SEWER
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
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 8w regulating construction or the
performance of construction. SEE REVEERSE SIDE FOR REQUIRED INSPECT a NS
DATE OF APPLICATION /.>//!J / SIGNATURE OF APPLI
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
o. Engineer
Utilities
Plans Examiner
SEPA Checklist
�IIdI icia Ridaw.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
PERMIT NUMBER
0.3* *500
*500
*5006
A *000
5639E
06-.09-81
B 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0:61;,,0I'1,4,8;111 5.6A 01
I 1'
*5.00x1 -
DATE ISSUED PERMIT NO. TOTAL