1983, 04-29 Permit: 83A-3498 PoolPLAN NUMBER
(1)
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. ick,
Cat—u .fv
PARCEL NO.
14.54=2 -ct 2�-Z
LOT
2.
BLOCK
SUBDIVISION
OWNER
3 N,
MAILING ADDRESS
)SII.(1bCc, CALL%l•.$
PHONE
PHONE
LEGAL DESCRIPTION: 'p'ry
ZIP
G�{�►Ga
Actual Set Backs in Feet to:
North 'South tic,i
11 East S' I est
4.
CONTRACTOR
5 A rneE
ADDRESS
4(hE
DESIGNER
5.
ADDRESS
LICENSE EXPIRES
PHONE
Size of Parcel
'X is/
W
Zone Classification
Residential
Commercial ❑
ZIP
Tygnst.
tU
Occupancy
1 ►t'Z
Sprinklered
❑Yes ❑No Req 'd.
PHONE
Neyf Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
7.
TYPE 4 NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑%IVE.
OF Cl BLD. ❑ PLMB. ❑ MECH. ❑ M.H. L PPOOL
WORK
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
Certifi. of Exempt.
or Variance
Required
Received
Yes❑ Noe
Yes❑ No❑
No. Dwellings
Number
DESCRIBE WORK
8. A3v 6-Zt2c4,-610
��p t✓
i'r)
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
Plans Required ❑
Received ❑
VALUATION
9. "Vi,z00
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC !
SEWER ❑
Ownership
Public E Private e
I hereby 'lenity 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. Thi, granting of a permit does not presume to give au-
thority to violate or cancel the •rovisions of any other ; -te -local law regulating construction or the performance
of construction. SEE REVE : SIDE FOR REOUIR • I PECTIONS
SIGNATURE OF
OWNER OR AGEN
APPLICATION i//4?
DATE
SPECIAL APPRO ALS
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECl/rL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM.J'i/
DATE �t61_ 4, A l c
IA
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home 25.00
Other (Speci
TOTAL $ ;ZSCO
PERMIT NUMBER
�3A .�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQSJUEI? 9 _ 8 3
pl
PERMIT4.9. u z
*25,uU AL