1981, 03-20 Permit: 81A-2623 Pool'""'"'�"`� APPLICATION/PERMIT
/ SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
11,� APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOTBLOCK U ON PARCEL NUMBER/S 09
2— �.-. 0
2. 10 �Pci A� +
OWN R
3.
hA-
ADDRESS
o
CONTR CTC
1 I�Ii'�V it�1�
NE
Zj P�1 Actual Set Backs in Feet
I_ _ � North ISO th PO
PHONE , Size of Parcel
C Q M
5�
4' ADr,RES
IP00
TypeConst.
1
Occupancy
Sprinklered
ii
h < I�
1
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
TYPE NEW ❑ALT. E] AWN. 1:1 RPL.
No. Baths
No. Stories
No. Rooms
No. of Dwellin
7
2rp/
WORK ❑ BLD. 1-1PLMB. I-]MECH. EIM.H. til PEl OTHER OOL
CERTIFICATE
Req'd.
Recd.
Not Reqs
of EXEMPTION
I
c/
DE�S�CRAIIP E WORKEnum.
Dist,
I Location (Area)
FEES COLLECTED
r 1
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership USE CODE
9. ����
UTILOITIES
����
Public ❑Private
Single $
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
Building
to give authority 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
Plumbing
DATE OF APPLICATION — �— Q SIGNATURE OF APPLICA��� mil
Meth.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
nv e h
O
anning
ngineer
Utilities
Plans Examiner
9
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify
TOTAL $
IPER,TIT NlJ1,4BE`R
02* *2700
`00
rl,
2 5, Z R _. 9
u�>6
—/G11
79,
L
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 t3r�<< 2�6 `8�'1� 2 6 2 3 * 2 5.0:0
DATE ISSUED PERMIT NO. TOTAL
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