1980, 07-21 Permit: 80-7395 PoolAPPLICATION/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 O OK `SUBD/IVIG l
2.
LEGAL DESCRIPTION - SEE ATTACHED
0 ER
3
ADDRESS ,pp
/D 7/1 O.ZQ a/7) -e- 4CJ a''L
C NTR TOR.
4.
ADDRErSS/ �ryj
DESIGNER
PHONE
ZIP
PARCEL NUMBER/S zsc'5-...c. - 3 -0
,(4.1('' 20 PC -b /6914.10 Si) Gi,',Vs J7;
PHONE
`�tl •^645
5. ADDRESS
ZIP
79 -
Actual Set Backs in Feet /
/ {ZZ • /1 / />
North if,/ ISouth�,� East /v (e (Westil
Size of Parcel i Zone Classificy,t,io.�nSprinklered
Type Const.
Occupancy
❑Yes ❑No 0 Req'd.
PHONE
Valuation • Building Area in q. Ft.
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
TYPE
7. OF
WORK
O NEW
O BLD.
O ALT.
❑ PLMB.
O AD N.
O MECH.
O RPL.
❑ M.H.1,4
❑MVE.
POOL
0 OTHER
Area ,of Desks
J _2/I—Jy4,1,
i/61,LL �/J
No. Baths I No. Stories
Finished Base
�
Unfin. Basement
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DF,SCRIBE WORK!
VALUATION} SOURCE
O
• gzidUTILITIES
Enum. Dist.
Location (Area)
GAS
EL9CTRIC WATER
SEWER
Ownership
Public 0 Private jc
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.ai rmit does not presume
to give authority to violate or cancel the provisions of any other state or local law re• ting construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPE j
DATE OF APPLICATION 7--.2/ �v
SIGNATURE OF APPLIC
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env.
Planning
044e
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu lding Tec niva
.e4 '77( ./j
z- ,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home ,{
Other (Specify) °"--
TOTAL
$ /2_5'.1G�'
PERMIT NUMBED
02* *2500
*2500
*25006
E *000 0
739.42
07-2180
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
74,toi *2`j®®te -
PERMIT NO. TOTAL
1.4,,2-(t/ !//62-64-
27- do6
792,r-
//ifees.
Koletv,e() -fri)to,1)97?--
72_ L07- -74t Aze.- oior e=,r
7
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