1979, 10-22 Permit: 79-6456 Swimming PoolJPLAN NUMBER
1
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
JOB ADDRESS
1. QPtts
!
LOT BLrOCK SUBISI
2. 1Lj sKyview
OWNER ' I
3. eti'A/ra
LEGAL DESCRIPTION - SEE ATTACHED
r4Cer5
ADDRESS (�
5' Q-55 8144eS
CONTRA TOR
4. I1fIAy MIDIS, C -Or f0
ADDRESS
J
F. got l y lac,
DESIGNER
Xie
5' ADDRESS
PHONE
9-2 q097
ZIP
7' 7'1.2J
j�
2z'! v
ONE
9_./g-Y9oa
PARCEL NUMBER/S
�u5 V9 o 7J 9
Required Set Backs in Feet
North 1/1-5- South
East ..7p 'West 93
Size of Parcel •
ZIP
PHONE n
ZI P
1.X 30 -360-VC -
Type Const. Occupai'icY
I;
berjhtSJ 4 -/A -
Zone Massif icaV .r
` Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
(/
DWL Area Basement Area
Building Area in Sq. Ft.
-3 0
Garage Area Storage
CHANGE OF USE FROM
6.
7.
TYPE
OF
WORK
4-114
TO
Si NEW 0 ALT.
0 BLD.
0 PLMB.
❑ AD'N.
O MECH.
4/9
❑ RPL.
O M.H.
Split Entry
Split Level
Rancher
❑ MVE.
tg POOL.
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9. '71, nao
Pr cJJ
G
R
,tJ 1�Y5
� -P„
Source
of
Utilities
ELECTRIC
tet -/n
WATER
N /q
SEWER
*jig
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. �r Q�
DATE ! L�'��' 1 SIGNATURE lr'tl X,
;A -L4
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
cx/b/
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
�1 ��jj
DATB/O 2.C-'/ OFFICIAL, a -(4'2I J LZ6 --
APPROVED FOR ISSUANCE
FEES COLLECTED
Single S
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
DATEJL-)._ n 7`1
02* *25,00
* 2500 t`n
* 25006
E *000
6455E
10-22-79
I 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES E�MIT.
O -7.9
7 6 4 5. 6 a
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s. asOs. RA�-�
-
73.13
the
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see
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