1981, 12-15 Permit: 81B-2745 Water SoftenerPLAN NUMBER
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
1.
JOB ADDRESS_
// y �cf
BLOCK SUBDIVISION
LOT
2.
f
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNE
DLi R ESS
(i4e.S
4.
CONTRICTOR
I Alie4 (.c.111,16)'2,tJ e,vS
(,7FON
ZIP
PARCEL NUMBER/S
Actual Set Backs in Feet
1South [East
North
'West
PHONE QYf�1�
44 -ii 76
Size of Parcel I Zone Classification
cue -7d7
DESIGNER
5' ADDRESS
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation 1Building 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
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
^�❑,�ALT. ❑ AD'N. ❑ RPL. 0 MVE.
I�.PLMB. 0 MECH. ❑ M.H. 0 POOL
El OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
DESCRIBE WOR.K„...
005 A /(' 674::
Enum. Dist.
`Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
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 gran ' g of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local I. regulating, construction or the
performance of construction. S E REVERSE SIDE FOR REQUIRED INSPECT 'NS
DATE OF APPLICATION
'4/
SIGNATURE OF APPLIC
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
r
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
3
03* *5.00
*5.00 N
*5006
A *0.00 S
274.4?
12-15-81
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12-1.35 `_.8 1
DATE ISSUED
27,155
PERMIT NO.
*500a� —
TOTAL