1982, 07-22 Permit: 82A-6314 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
1 LOT'
2. /
OWNE
3.
BLOCK
cHA Of,
SUBIVISION
LEGAL DESCRIPTION - SEE ATTACHED
1,01-1A Al c' fcoO,
PARCEL NUMBER /S
PHONE
- 2 %CT2
ADD SS
12-x' d ' L elvic c i ,
4. CO i,R* 1 -O41
pct..) t I(i oc )
ADQES . -2 C f1� Y 9
DESIGNER
,.
5' ADDRESS
ZIP
9920
PHONE
PHONE
Actual S t Backs in Feet
North 'South
East • 6
'West
Size of Parrceel
nst. .
r
Occup cy
Zone Classification
771 kk Le
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
Er/NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. i POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8. a�I•.i 1 hi rccL, 7 (lam >
VALUATION SOURCE GAS LECTRIC WATER
g, 000
UTILITIES
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Redd.
SEWER
i
Ownership
Public ❑ Private
USE CODE
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 ('l APPLICATION ` — /( �12 SIGNATURE OF APPLICANT
�R
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
En ealth
fanning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildin Teech
v.
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
O eery (Specify)7
TOTAL $ ,{/n
PERMIT iVetNII8ER
02* *2500
*25.006
A *0.00
600.12
07 -14 -82
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07 =2 82 6 3 1 4 5 * 2 5 0 0 8
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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