1982, 03-29 Permit: 82A-2275 Pool1
PLAN 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 BL CK SUMO. VISION
2. , 3 V OSA VA l lz°
PHON
72i7
ZIP
PHzO Eg
4. -s27q
IP
PHONE
3.
AD ESS
2^
-r
CONTR CTOR�
Gj- c7nl PQoV
DgREJISS
DESIjIGNEF7
5. ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
ZIP
PARCEL NUMBER/S I4- 9 ,{ 2 — 1015
Actual Set Backs In Feet
North South I0 Eas!C9 (West
Size of Parcel Zo a Classification
Typq Const. Occu y Sprinklered
N�•V( ❑Yes ❑No ❑ Req'd.
Valuation97-576-41
4'
Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
CJ NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MJd E.
0 BLD. ❑ PLMB. 0 MECH. 0 M.H. E POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Rea'd.
8.
DESCRINE
I))IWOR.AKyyrrAA'''
ALTION�ptj ICE
OF
UTILITIES
9. 97j
Enum. Dist.
Dov
Location (Area)
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private Itif
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 grant g . a permit does not presume
to give authority to violate or cancel the provisions of any other state or local aw r gulatine construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPEC r ON
DATE OF APPLICATION 3
SIGNATURE OF APPLICAN
•
4
SPECIAI, APPROVALS
NAME DATE
Env He It
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
echnl
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
ch.
Plan Check
SEPA
Mobile Home
Other (Specify).
TOTAL $-715
PERMIT NUMWER,.
bzA
02* *25,00
*2500 rn
*251006
A *0.00
227.-42
03"-29--ti2
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
03.-19.x812 227.52 *25.002'F-2 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT NO.
T` TA
i,SPOKANE COUNTY I-IEALTH DEPARTMENT
E. 0. PLOEGER, M.D., Director of Health
Division of Sanitation
i../ ‘:
N. 819 Jefferson DATE -
—ti e Spokane 1, Washington
• PERMIT NO
At,: 5 •
1 . • APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES •
7
N? 16583
• Namele. O. At -C -41.4.--V. Cr- X2CHI:-/ ss.
/ 3 rivi )4, • •
11-eJL-‘eArAddre
Address of Propose ? V V )7
Type of Use
• ' Number of Bedrooips C Building Capacity
Size of Property..../ V. 9 "( 9 ,•
Is basement for building planned' c.
Camp Capacity' Other •
• Water Supply (City, Well, Spring). Drywell
Septic tank capacity
.
• Length of disposal field
. •
0 C.) gals.. Style M tank
/
' . "(1)' Draw in property area to Scale. • •
• ' •'5. • .
:(2) Show relative location 'of: Proposed. house, septic tank,
•'14‘1•I' • 4 dirposal. field, Well, katkage, and other out buildings.
' s(3) Make note of any heitvy slope or, swampy area or any
• •# • :other Important topographic details. .
•
•
•
•
. ' •
,
•
•
• ,. 94•
• , •• °!.
• • •
• 0 ° •
/
•
• • .• ‘t•
•
. . •
Leaching Bed •• Dist. ]Box. '• •
12, . zip.; • , • ..:.; .
. • ;_, • ;Tr:. • , ,
• , • •. • 9 ;',-;;;Y
, • ‘• ;„-.;;
• h ^
, ,••
I' '40
'-t,;:sk,,•:r'
.: ,Ic•
i 3 I -., .pi ., .:1-----,-.7-7--„,. 6.
IC- , Niri: St/Ai • '. :.- c,,,,);•:: :.• ?„ .v . 8: 1 • . :..;;;31?
, .. ..„.
It': it
- ‘ 5 frig • ' .
#24- ; 9:: . • ' '.' : : -2 C, s , ., • j.21:
1 .1 61? i:" S: ri ' -.-t .c:i - . 9.- t/41 %PIPlitili10I4,1A/C5.1
pectlon Date Y....Li
• .• • IS‘? artir .e
• Remarks:W/1/ ‘•:) ' /
tT
•
•CONTRACTOR...2Wift RECOMMENDED PERMIT BE '11.c
(FH. :.411ev. Health - 581 - 9/58)
By
Sanitarian