1981, 04-09 Permit: 81A-3334 Water SoftenerPLAN NUMBER
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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
1. 6 • I7 -5t4 1-10}1kLOT BLOCK UBDIVI ION
2.
LEGAL DESCRIPTION - SEE ATTACHED
3.
OW R
o 6. boLL, fr
-
AD� I25D4- FFoLJK
CO VTRACTOR
`t'c ktiviesNI
CJIcg
4'
ADDRESS*,
.3-44 fe t Ante
DESIGNER.
ADDRESS
5.
PHONE
`)2.6-755b
ZZII P/�
✓ ^140
PARCEL NUMBER/S
Actual Set Backs in Feet -
North 'South
East
'West
PHONE
43tfl
t ?)
Size of Parcel
Zone Classification
ZIP
99.244
PHONE
Type Const.
Occupancy
Sprinklered
Oyes DNo 0 Req'd.
Valuation •
Building Area In Sq. Ft.
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
E NEW
❑ BLD.
0 A T. 0 AD N. 0 RPL. 0 MVE.
MB. 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.
8.
DESC I7Bs�E WOO�RK
aRl�
VALUATION
9.
wf I
GAS
SOURCE
OF
UTILITIES
Enum. Dist.
Location (Area)
ELECTRIC
WATER
SEWER
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 law regulating construction or the
•
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS •
DATE OF APPLICATION—f—I1/7)
0 [� SIGNATURE OF APPLICANT •
SPECIAL APPROVALS SPECIAL CONDITIONS:
• NAME DATE
Env. Health
, Planning
Co. Engineer
Ut i l it les
Plans Examiner
/sr{ P,kie5-•
• 3 I%.'rn /3e. h/A/c1 G 4 •
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing •
Mech.•
Plan Check
SEPA
5. d°
Mobile Horne
Other (Specify)
I"" 0 0
TOTAL $
e
PERMIT NUMBER
j"' 37?34-
03* *5.00
*500
*5006
A *000 8
33,3.32
- 04-0978:1
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'• 4
O,� ai41y Blli1,
DATE ISSUED
313;3'4 =.
*5,O:O. _
PERMIT NO. TOTAL