1981, 09-08 Permit P81A-9027 Water SoftenerPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
3.
4.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
I�
LOT BLOCK SUBDI l N
LEGAL DESCRIPTION — SEE ATTACHED
OWNER_W , 0I-4 0\
ADDRESS1 Fc izef
CONTRACTOR
j „c�� 6°)
ADD2ESSr� i
DESIGNER
5. ADDRESS
PHONE ,_r1?
ZIP
PH��^^ON
P
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
Size of Parcel Zone Classification
PHONE
Type Const.
Occupancy
East
'West
Sprinklered
Des ONO ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
6.
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
0 NEW ❑ /ALT.
❑ BLD. E PLMB.
❑ AD'N. ❑ RPL.
❑ MECH. ❑ M.H.
El MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
DESCj2,I6E lK
8. VALUATION GAS
SOURCE
OF
UTILITIES
ELECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public ❑ Private
Req'd.
Location (Area)
I
USE CODE
9.
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 r
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
EPA Checklist
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
5vO
TOTAL $
06* *5,00
500 rn
*5.000
A *0.00 8
90262
09-08—'81
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i0 at- 8 `l
Building
TecMlician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED
902,7z
*5.00a.
PERMIT NO. TOTAL