1981, 04-30 Permit: 81A-4144 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.
2.
3.
4.
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK VISION
PAREL NUMBER/S
OWNER
ADDRESS
50- IiKfF2 4-7--1
PHONE
4oI I
ZI P
Actual Set Backs in Feet
North !South
East
'West
CONTRACTOR ✓� ! t?
ADDRESS
PHONE
Size of Parcel I Zone Classification
IP
Type Const.
Occupancy
Sprinklered
❑Yes ENo ❑ Req'd.
5.
DESIGNER
PHONE
Valuation 1 Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
ZEW ❑ ALT. 0 AD'N. ❑ RPL.
PLMB. 0 MECH. 0 M.H.
0 BLD.
Area of Decks
Finished Basement
Unfin. Basement
0 MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DESGRIB�E' {NWORK
Mt' ^y7� 1
VALUATION SOURCE •GGA`S ELECTRIC
OF
UTILITIES
Enum. Dist. I Location (Area)
WATER
SEWER
Ownership USE CODE
Public ❑ Private ❑
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
Zo '1
cov
SIGNATURE OF APPLICA T
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
r 'o
TOTAL $
PERMIT NUMBER
Sc - 4- 14-1-
03* *500
*5.00 V)
*5,006
A *0.00
414.32
04-30-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
f
0>4 �'Q;-8 1,
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT4ND." 4 Z
*-042u--2