1981, 07-28 Permit: 81A-7577 Swimming PoolPLAN 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
JOB ADDRESS
SC;c,„ Aoilar►�s�
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK SUBDIVISION
OWNER
3. JAV'. 5 C.2 M-VT(1 N
PHONE
PARCEL NUMBER /S zJ'
vERv,
ic2 or iv of .
14544-004a
ADDRESS
S SvC le4b44n1(
4.
CONTRACTOR
CMfE -LIf4`. �tGGc.�,
ZIP
PHONE
4-$C1— 6-, 74-
Actual Set Backs in Feet
North JO 1South 4•
`/i yy
East 77 1 'West
Size of Parcel
ADDRESS
N . 5 t so FQE*ii R
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ZIP
,'
`"l!M Ze)- 7
PHONE
ZIP
TO
VNEW ❑ ALT. ❑ AD'N.
❑ BLD. ❑ PLMB. ❑ MECH
DESCRIBE WORK
• :MA. 1k..;��
�
�ALUATION y
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 constructi n. SEE REVERSE SIDE FOR REQUIRED INSPECT!' S
DATE OF APPLICATION _ SIGNATURE OF APPLICANT •I �..
❑ RPL.
. ❑ M.H.
❑ MVE.
NI POOL
❑ OTHER
�14y�3Zi
SOURCE G S ELECTRIC WATER
OF
UTILITIES
I�x
Typ Const.
Zone Classification
ZS 1 L•,, 5.4.3uwAr.)
Occupancy
� -Z
Sprinklered
❑Yes ❑No ❑ Req'd.
Valu
Main Floor
Building Area in Sq. Ft.
iz
Upper Floors
Garage Area
Area of Decks
Finished Basement
Storage
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
SEWER
.err 1(„
Ownership
Public ❑ Private
Req'd.
USE CODE
SPECIAL APPROVALS
NAME DATE
Env. Health
fat 9 t O..
nning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B ildin Technician
4.
SPECIAL CONDITIONS:
bizieh1w)AL ?FenJeo l'wr Pig AiT J -46D
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Noq'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)Z
C�'GSCac-
TOTAL $
PERMIT NUMBF.
8I --7s11
G2* *25.00
*25.00
*25.00
A *0.00 8
757.68
07- 28-81
2 6,479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 lIB�`1'
DATE ISSUED
757.72 *25.40;0 e
PERMIT NO. TOTAL
5r7E. PLAN
i
I-F;(0 , 0a5C.RiPTiCN
THE 5aJ ^N
1C2 FT. °I- THE NCPS^,°
°F EXCEPT -r J,5-' 2
•
3