1979, 07-27 Permit: 791183 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 4 COPIES
1.
2.
3.
4.
JOB ADDRESS
LOT
B
_OCK
SUBDIVISION
OW RIR QSS
`11 -i�
1 AMIL ,1
AO D�E,i7 I-7 AN-
Cat-rAR,
ADDRESS
PHONE
ZIP
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER / 107
eiSS13 —tle
p1 OF BACK lrr;; c_o'T 6, 81 -oc/r / NEW APP.
b R tr/ L�( 77 -16;._ fkLW I S U PII V I°N [_.o -r 7, FL
Requi d'Set Backs in reef
North 130' 'South [East 9L-/-` 'west /LP 4
Size of Parcel
2/1/,81 x Z70'
Zone Classification
A ICULTURkL
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
$'‘90009-
ZIP
DWL Area Basement Area
Building Area in Sq. Ft.
738
1 Garage Area I Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
i NEW ❑ ALT.
❑ PLMB.
❑ BLD.
TO
Split Entry
Split Level
Rancher
❑ AD'N.
❑ MECH:
❑ RPL. ❑ MVE.
❑ OTHER
❑ M.H. POOL
No. Baths
No. Floors
CERTIFICATE
of EXEMPTION
No. Rooms
Rec. Room
Req'd.
Rec'd.
Not Req'd.
DESCON4WO R K.
8. I M VI 1 [lel r(2
VALUATION Source GAS
00 of
9. � 0 Ax Utilities
ELECTRIC
WATER
SEWER
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.
DATE 7--'/ - 7 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
3/-7
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
77 OFFICIAL
APPROVES FO' ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE JulLV 13/ 1'17
02*
*47.00
*47.00
*47.006
e *0,00 g
118.2
07 -27 -79
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07 -27 -79
118,32
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
s"00P,
*�aco
S* 41.100