1981, 03-23 Permit: 81A-2662 Water SoftenerAPPLICATION/PERMIT
SPOKANE COUNTY -- BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
`J APPLICANT:
COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
�
Garage Area
Storage
LEGAL DESCRIPTION — SEE ATTACHED
J
7 >
Area of Decks
Finished
Basement
LOT
BLOCK
PARCEL NUMBER/S
2.
I
I-SUISDIVI51CYN
No. Stories
No. Rooms
No. of Dwelling
OWNER�f
�
PHONE
F.:L? U!
3. �'� '
CERTIFICATE
Req'd.
Recd.
Not Req'd
ADDRESS
WORK
of EXEMPTION
ZIP
Actual Set Backs in Feet
L. , f .. ' �� ��
'J i/�-%!�'
8. {/ lJ�f� "
North South East West
CONTRACTOR
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
PHONE
Size of Parcel
Zone Classification
typeof 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 0 -
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION �'� —/ SIGNATURE OF APPLICANT
Mech.
4' ADDRESS
NAME DATE
ZIP
Type Const.
Occupancy
Sprinklered
i' n ---- ,
� A
� Gz ::).:�—
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished
Basement
Unfin. Basement
6.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPE ❑NEW 1-1 ALT. El AD'N. El RPL. El MVE.
7. OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd
El BLD. J4 PLMB. ElMECH. [IM.H. El POOL
WORK
of EXEMPTION
DESCRIBE WOR)< Enum. Dist. Location (Area) FEES COLLECTED
8. {/ lJ�f� "
VAL ATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. 1UTILITIEOFS
Public ❑Private ❑
Single $
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
Building 4#
typeof 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 0 -
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION �'� —/ SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
ans Examiner
nn PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
PERMIT NUMBER
001
u3* *`GO
q
*�.L,0u
r
2661
03 -23 -?1
2 6479,
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6 2 Z
DATI SUE�I�+�D PERMIT NO.
E i
*5.00 aIJ-
TOTAL.
C
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