1984, 03-29 Permit 84A-2702 Wtr SoftenerPLAN NUMBER
APPLICATION/PERMIT
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 ADDRESS
1.
LOT
2.
/99d/4". ed I ze) iJ
BLOCK SUBDIVISION
OWNER
3. �: / i ((.Qit
MAILING ADDR SS
/U /2�. 6041(6.0(/(1_
CONTRACTOR
4.
5.
ADDRESS".
DESIGNER
PHONE
02 Ir3/
LICENSE EXP RE
PHO E
153 72U47
ZIP
PHONE
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs In Feet to:
North ISOuth [East I West
Size of Parcel
Type Consl.
Occupancy
New Const. Valuation
Zone Classification
Residential 0
Commercial 0
Spr'nklered
❑Yes ❑No ❑Req'd.
Remode ed Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
G eenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ❑ NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF
WORK ❑ BLD. X PLMB. ❑ MECH. ❑ M.H. CIPOOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes No❑
Received Yes❑ No❑
Number
DESCRIBE WORK
8. 7(:ale
VALUATION
9.
SOURCE GAS
F
UTILLIITIES
ELECTRIC
WATER
PUBLIC ❑
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER ❑
Shorelines/Flood Haza d Plans Required ❑
Vest] NotApplic. ❑ Received ❑
Ownership
Public 0 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 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 REQ IRED INSPECTIONS
SIGNATURE OF / OWNER OR AGENT APPLICATION DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing �( .)4
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
Sher
PERMIT NUMBER
84A - 2-7v2
04* '4"20.00
*20..00�
*0.00
270,12
03-29-84
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED22 9 - 8 `i
PERMIT2N . ' 2
*20.U0'o4AL