1983, 04-06 Permit: 83A-2705 PoolPLAN NUMBER
v
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
N.1440 > �T
PARCEL NO.
4`)
2.
3
LOT
Ia
OWNER
BLOCK
SUBDIVISION
1 - �0+�• 'Cd QC -2A f:7) (-.e„ �T5
OA\/E 't ('..Arwt._
PHONE
PHONE
Qa23 ?8
LEGAL DESCRIPTION:
MAILING ADDRESS
J; • 440 �T
CONTRACTOR
4.
ADDRESS
N. tll�i
DESIGNER
5.
ADDRESS
ZIP
Qat
LICENSE EXPIRES
PHONE
Actual Set Backs in Feet to:
North "South '
11 East ,v I West
Size of Parcel
Zone Classification
2-1
ZIP
cA'
Type Const.
Occupancy
Residential r
Commercial ❑
Sprinklered
❑Yes ❑No ❑ Req 'd.
CHANGE OF USE FROM
6.
PHONE
ZIP
TO
TYPE INEW ❑ ALT. -1 AD' N. ❑ RPL. 17 MVE.
7. OF
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ElM.H. LSI POOL
❑ OTHER
New 9gpst. Valuation
Main Floor
Cover Deck
Remodeled Valuation
Total Bldg. Floor Area
Upper Floors
Garage/Storage
Greenhouse
Uncv. Deck
Fin. Basement
Unlin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required
Received
YesL NoC
Yes❑ Non
Number
DESCRIBE WORK
O.
VALUATION
LUG x
SOURCE
F
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE,'
SEPTIC No
SEWER ❑
Shorelines/Flood Hazard
Yes'C Not Applic.
Ownership
Public C Private ❑
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 au-
thority 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
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
EPA
Plans
Exam
`)'Gly
Building
Tech
5;54
4 f'K
APPLICATION/(? /y
DATE (((
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
0/4t
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required fl
Received "'
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SE PA
Modular/
MFG. Home
Other (Specify) ZS • CEJ
TOTAL $ ".0d
PERMIT NUMBER
e,"SA - Z7o5
02* *25.00
*25006
A *0,00
270,4
04-06-83
6479.
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
DATEUEDO 6
- 8
PERMITO. 0 z * O O TOTAL
Sto ra.9c-
Getra5
Occi-
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