1983, 11-15 Permit: 83B-1715 Water SoftenerPLAN NUMBER APPL LCAT ION /PERMIT PERMIT NUMBER
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
STREET ADDRESSPARCEL NO.
1 E. 13112 - 29th
LOT I BLOCK I SUBDIVISION I LEGAL bESCRIPTION:
a
OWNER
3 Douf;las J. Kolczak
MAILING ADDRESS
Sarre
CONTRACTOR
Soft Water Service
ADDRESS
E. 25 Third Ave.
5.
ADDRESS
PHONE PHONE
928-3277
ZIP
99216 -
LICENSE EXPIRES PH NE
455-8050
ZIP
99202.
PHONE
ZIP
Actual Set BacKs In Feet t(
North I South
Const. I Occupancy
Main Floor I Upper
East I West
cone ciassmcauon I Residential ❑
Commercial ❑
Sprinklered
Dyes El No ❑Req'd.
ad Valuation Total Bldg. Floor Area
Garage/Storage I Greenhouse
6 CHANGE OF USE FROM I TO ' Cover Deck I Uncv. Deck I Fin. Basement I Unfin. Basement
No.
TYPE n NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 OF El OTHER
WORK ❑ BLD. ElPLMB. ElMECH. ❑ M.H. ElPOOL FCA01
No. Floors I No. Fin. Rooms I No. Dwellings
Received Yes❑ No❑
DESCRIBE WORK Shorelines/ Flood Hazard Plans Required ❑
8• Water Softener Yes Not Applic. ❑ Received ❑
VALUATION I SOURCE GAS ELECTRIC WATER I SEWAGE Ownership FEES COLLECTED
9 OF PUBLIC El SEPTIC Elpublic El Private ❑
UTILITIES PRIVATE ❑ SEWER 1-1
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 Building
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 Plumbing
SIGNATURE OF,oft Water Service Co. APPLICATION 11/11/83
OWNER OR AGENT DATE Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning Modular/
MFG.Home
Fire
Prevent.
Other (Specify)
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
TOTAL $
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
DATEtISS41ED1 n 3 PERMIT1I9. 1, 5 0 * 7. 0 0'0011AL