1981, 03-23 Permit: 81A-2664 Water SoftenerPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — e3UILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
,., IlI ally (�
LOT LO UBDIVISION
2.
LEGAL DESCRIPTION - SEE ATTACHED
0/V1(NERye%
PHONE
7740
PARCEL NUMBER/S
A
DRESS
/yij 741/0.-/---c:1,4, (',4,.,
CONTRACTOR
4.t % /`7/92t .) ,,,A -i ( rte :el--
AD ESS
/41- i .. c .-.-/S . ---7)k- 4,-/-6-44..,e---
DESIGNER
5. ADDRESS
ZIP
47677/7
PHONE
Actual Set Backs in Feet
North (South
Size of Parcel
East
(West
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
O NEW
❑ BLD.
❑ ALT.
PLMB.
❑ AD N.
❑ MECH.
❑ RPL. 0 MVE.
0 OTHER
❑ M.H. ❑POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
Enum. Dist.
ILocation (Area)
9.
VALUATION SOURCE
OF
UTILITIES
GAS
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 :3—'41,5 - c{i / SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
:-t,
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing <
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $� t�
p
PERMIT NUMBER
*5,00
*500
*5,00
*CID 0
266.
03-23-81
6rs7s
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
013;x-2' ,-'8 1 266.4.5 *500 112