1982, 07-12 Permit: 82A-5879 PoolPLA" ITJMBER'
APPLICATION/PERMIT
GAS
ELECTRIC
WATER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
Ownership
G
OF
UTILITIES
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT:
COMPLETE NUMBERED SPACES - PRESS
HARD TO MAKE 3 COPIES
f
JOB ADDRESS
S 4U\0%
LEGAL DESCRIPTION - SEE ATTACHED
z ( w
Single $
LOT
BLOCK
on reverse side, and know the same to be true and correct. All provisions of la
PARCEL NUMBER/S
2.
s
1 \
ISUBT51VISION
�oKLcs i
�lE IAf� ow��
regulating constr Ion or the
OWNER
performance of construction. SEE RE ERSE SIDE FOR REQUIRED INSPE IO
PHONE
3.
-S w.
Iv1c��S-f
et -a. -:;U3
-3'3'S 4-3 - O1 v5"
ADDRESS
ZIP
llp�'--7ckep
Actual Set Backs in Feet i
-` o1dr1
Y -d ST
7wE
R� �e
North South East West 112
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
cusYa �,
�ooc.
A-s-D-�-►
+vs)c
12-1
4.
ADDRESS
Zip/
Type Const.
Occupancy
Sprinklered
Q,
11A�< �1f+z
61C Ar—
��•--Z
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
VAuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area Storage
c:HANUL OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
s.
TYPENEW ❑ ALT. ❑ AD'
No. Baths No. Stories No. Rooms No. of Dwellings
N. 1:1 RPL.❑ MVE.
7, OF ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. LJ POOL 1:1 OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area) FEES COLLECTED
8. -;:. w t T-Cka
VALUATION1 SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
OF
UTILITIES
T ��
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 la
nd ordinances governing this
type of work will be complied with whether specified herein or not. The gran ng
f a permit does resume
Building
to give authority to violate or cancel the provisions of any other state or Ioca la
regulating constr Ion or the
performance of construction. SEE RE ERSE SIDE FOR REQUIRED INSPE IO
S
Plumbing
DATE OF APPLICATIONy SIGNATURE OF APPLIC
SPECIAL APPROVALS SPECIAL CONDITIONS: I
NAME DATE Plan Check
Env. Health
414
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
n PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify) 2c 42T
TOTAL $ 2s."
PERMIT iTUMBE e lf
02* *25.00
*25006
A *000 00
5878
07-12-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'7-if�.82; 587,92
nATF ISSiiF:n PERMIT NO
t
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