1981, 03-23 Permit: 81A-2656 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
2.
JOB ADDRESS
�
/(,
LOT I iLOCK S ff
DIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER
3 T Le �Qxr�
ADDRESS
//// G• A/' .
CONTRACTOR j
4. f���/�; fd�'Crf�L"x90�f�1 �C f. (_,87 -
ADDRESS
PHONE
ZIP
-.c,e-)‘0
PHONE
Actual Set Backs in Feet
North (South East 'West
Size of Parcel
Zone Classification
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
O BLD.
0 ALT.
jI PLMB.
ZIP
PHONE
ZIP
TO
O AD'N.
❑ MECH.
O RPL.
O M.H.
O MVE.
O POOL
0 OTHER
Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
No. Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
Storage
Unfin. Basement
No. Stories No. Rooms No. of Dwellings
DESCRIBE WORK
8. sr�t / 7,a -F-
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
SEWER
CERTIFICATE
of EXEMPTION
Enum. Dist.
Req'd. Rec'd.
Location (Area)
Ownership USE CODE
Public 0 Private 0
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
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Te hnician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
7/4__
03*
A
26552
03-23-81
2 6479.
*5.00
*500
*5006
*0.00 3
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'3-23-'81: 265.62
DATE ISSUED PERMIT NO.
*5.00ar2 —
TOTAL