1984, 01-19 Permit: 84A-564 Water SoftnerPLAN NUMBER I APDL IGAT ION / 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
STREETADDRESS PARCEL NO.
1 • N. 1223 Dick
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNER
3 Jerry W. Nelson
MAILING ADDRESS
Same
CONTRACTOR
A Soft Water Service Co.
ADDRESS
E. 25 Third Ave.
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
TO
18
ZIP
99206
LICENSE EXPIRES PH NE
x+55-8o5o
ZIP
99202
PHONE
North
Size of Parcel
Type Const.
ZIP ■ Main Floor
TYPE A NEW ❑ ALT. ElAD' N. ❑ RPL. ElMVE. ❑OTHER
South I East I West
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CertifLofExempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
8 DESCRIBE WORK Shorelines/ Flood Hazard Plans Required ❑
Water Softener Yes Not Applic. ❑ Received ❑
VALUATION SOURCE GAS ELECTRIC PUBLICO SEPWTAIC O Ownership FEES COLLECTED
9 UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
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 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
OWNER OR AGENT `aoftWater Service Co. DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE
PRELIM. FINAL DATE
Env. Health
Planning
Prevent.
Enoineer
Plans
Exam
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Building
Plumbing: `
Mech.
Plan Check
SEPA
Modular/
MFG.Home
PERMIT NUMBER
00-��
Other (Specify)
TOTAL $ ti
WHEN MACHINE VALIDATED IN THIS SP
THIS BECOMES A PERMIT.
DATE"i'Cli i— 84 PERMITJ V. 4 z * 5. 0 0 TOO UL
C
O
U
W
J
LL
cone ciassmcauon
Residential ❑
Commercial ❑
Occupancy
Sprinklered
Dyes El No ❑Req'd.
n
Remodeled Valuation
Total Bldg. Floor Area
Upper Floors
Garage/Storage
Greenhouse
Uncv. Deck
Fin. Basement
Unfin. Baseme
4o. Floors
No. Fin. Rooms
No. Dwellings
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CertifLofExempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
8 DESCRIBE WORK Shorelines/ Flood Hazard Plans Required ❑
Water Softener Yes Not Applic. ❑ Received ❑
VALUATION SOURCE GAS ELECTRIC PUBLICO SEPWTAIC O Ownership FEES COLLECTED
9 UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
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 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
OWNER OR AGENT `aoftWater Service Co. DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE
PRELIM. FINAL DATE
Env. Health
Planning
Prevent.
Enoineer
Plans
Exam
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Building
Plumbing: `
Mech.
Plan Check
SEPA
Modular/
MFG.Home
PERMIT NUMBER
00-��
Other (Specify)
TOTAL $ ti
WHEN MACHINE VALIDATED IN THIS SP
THIS BECOMES A PERMIT.
DATE"i'Cli i— 84 PERMITJ V. 4 z * 5. 0 0 TOO UL
C
O
U
W
J
LL