1981, 12-30 Permit: 81B-3048 Water SoftenerPLAN NUMBER
APPLICATION- 4'ERMIT
SPOKANE COUNTY — BUIL[' =,'CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, -r1 ._GTON 99260 / (509) 456-3675
APPLICANT: COMPLET NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1. JOB ADDRESS /a6 1 LEGAL DESCRIPTION - SEE ATTACHED•
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
3.
OWNE
RESS
CO !T/J
ACTOR
(V2
PHONE
9af �i‘
ESS 16
DESIGNER
6' ADDRESS
PH / E4,sr A�
., —/i 7 d
Actual Set Backs in Feet
North (South
Size of Parcel
E
est
Zone Classification
Type Con
Occupancy Sprinklered
Oyes 0No 0 Req'd
PHONE
Valuation
Building Area in Sq. Ft
ZIP
Main Floor
Upper FIOo
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basemen
Unfit). Basemen
TYPE
7. OF
WORK
O NEW
❑ BLD.
—
DESCRIBE NIORK
8. fly,-utt Wz iZ
VALUATION SOURCE GAS ELECTRIC WATER
OF ly
9. UTILITIES 4'C
DALT. 0 AD N.
LIg PLMB. 0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
0 POOL
❑OTHER
No. Baths
No. Stories
No. Room
No. of Dwelling
CERTIFICATE
of EXEMPTION
Reg
Recd
NOt Req'd.
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private 0
USE CODE
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 authority to violate or cancel the provisions of any other state orcal law regulati. r construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSCTIONS
DATE OF APPLICATION • /
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Englnee
Utilities
Plans Examiner
SEPA Checklist
echnl
SIGNATURE OF A
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building h/�
Plumbing �./ od
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
S `✓ -- 304"0
03* *500
*500
*5.006
A *QQ0 0
30Q7g
X12-30-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1,Q;71'510 81 .
DATE ISSUED' PERMIT NO.
30,48'5
*5.O0
TOTAL
T
0
0
0
UJJ
ly