1982, 05-21 Permit: 82A-4006 PoolPLAN 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.
E • 1°4%4- Evv\--Ptiae
LEGAL DESCRIPTION - SEE ATTACHED
2.
3.
4.
LOT
BLOCK
SUBDIVISION
OWNER
MEL.
PHONE.
c a.ej'S
PARCEL NUMBER/S Cy,i1iAY.�L7l3L AC.a
Nt..-1 ma' L. csT LB
•
iiZQ
ADDRESS
i.. LO«l 14c E
CONTRACTOR
ADDRESS
SawtE
ZIP
G61 2e,C.
Actual Set Backs in Feet
North 'South Cod
East
1West` 1
• PHONE
Size of Parcel
t XTl0
Zone Classification
AC:42JG,uI�.TU.a_4L
ZIP
Tye Const.
6.3
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
ADDRESS
ZIP
Va uattion
unnioor
M
Building Area in Sq. Ft.
1(0)<3-1—
Upper Floors
' Garage Area
•
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE 0 NEW
7. OF
WORK
0 BLD.
DESCRIBE WORK
8. Sc..L.1 Al
SOURCE
OF.
UTILITIES
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL. 0 MVE.
❑ M.H. POOL
0 OTHER
No. Baths
No. Stories
:No. Rooms'.
No. of Dwellings
CERTIFICATE
of EXEMPTION__
Req'd.
Rec'd.
Not
q'
VALUATION
'\C,60
Enum. Dist.
Location (Area)
GAS
ELECTRIC
WATER
SEWER
SEeTiC
Ownership ,,_//
Public 0 Private �0
USE CODE
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 re•:. atinction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATIO
• / 24--"."-- SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Ith
2M# 1/29
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SP
CIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single . $
Building
Plumbing
Mech.
PIan Check
SEPA
Mobile Home
Other (Specif 2Q
?ec)L
TOTAL $ 2 c•
PERMIT---iiUM R
02* *2500
*25.00 1-6
400,5'
05 2182
z. 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•4.
•`,0 91
i _1812' 4110';0'`6
DATE ISSUED- PERMIT NO.
2.5,0
TOTAL
%ad. .kaa.
- - .
%-•