1983, 05-13 Permit: 83A-4064 Pool Cover BldgPLAN NUMBER APPLIICATION /PERMIT
SPOKANE COUNTY -- DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESIGNER
ADDRESS
ZIP
APPLICANT: COMPLETE NUMBERED SPACES —PRESS
HARD TO MAKE 3 COPIES
Sprin Bred
STREETADDRESS
i L _
V
A, —i
Dyes ❑No ❑Req'd.
PARCEL NO.
PHONE
1.
.F• I J X5104
C-?Lr,-P{VIF_W
GIP ca.E.
. e5`fl-- 1801
2
2'LUVT'
LOT
BLOCK
SUBDIVISION
ZIP
LEGAL DESCRIPTION: LO I "p --rqr,
Upper Floors
Gerage/Storage
Greenhouse
`> 13LOcK- Z
� LENVIeO "`�
FIJZ.�;( A -PD'
OWNER
PHONE
PHONE
3.
A R -n4(4
k 1 e -k
741
MAILING ADDRESS
Zipr
Actualt Backs in Feet to:
r.. U L � VI E W)
� 1 2.0 a,
North South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel f
Zone Classification
ResidentiaKB'
4.
t3;;, ?t 110
SOX L
Commercial ❑
DESIGNER
ADDRESS
6.
No. Baths No. Floors No. Fin. Rooms No. Dwellings
TYPE I!rN EW ❑ ALT. El AWN. El RPL. ElMVE. t
7• OF❑ OTHER _
WORK 1''BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi. of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
DESCRIBE WORK Shorelines/ Flood Hazard Plans Required
8 ''OC ccV Wu))K 36 t)r 52 Yes❑ NotApplic. ❑ Received
VALUATION I SOURCE GAS ELECTRIC WATER SEWAGE Ownership
9 OF PUBLIC SEPTIC public ❑ Private FEES COLLECTED
UTILITIES PRIVATE ❑ SEWER El
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included o I . Q
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building
work will be compiled with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRE INSPECTIONS Plumbing
SIGNATURE OF , APPLICATION
OWNER OR AGENT DATE ' 1 —�3 Mech.
SPECIAL APPROVALS SP CIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FIN#L DATE �`��_�(,, � ^ � � � � RAW_
Plan Check
Env. Health �! V / I t`�rV `'
�/ SEPA
Planning �6
Modular/
Fire MFG. Home
Prevent.
Enoineer Other (Specify)
Utilities 1 00
TOTAL $ _..t1=/1_0
SEPA
Plans PERMIT IS NONTRANSFERABLE WHEN MACHINE VAR
IDAExam. i Y THIS BECOMES A PERMIT.
' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech. ing 7 IN 180 DAYSI' 55 _
5 li
DAT EDI —
P��-Rx�UMBER
PERMIT N�. 6' z 10 fO'FAL
u
ZIP
Type Const.
Occupancy
Sprin Bred
i L _
V
A, —i
Dyes ❑No ❑Req'd.
PHONE
New Cot. Valuation
Remodeled Valuation
Total Bldg. Floor Area
IT
2
1(f7Z-
ZIP
Main Floor
Upper Floors
Gerage/Storage
Greenhouse
A
TO
Cover Deck
Uncv. Deck
Fin. Basement Unfin. Basemen
6.
No. Baths No. Floors No. Fin. Rooms No. Dwellings
TYPE I!rN EW ❑ ALT. El AWN. El RPL. ElMVE. t
7• OF❑ OTHER _
WORK 1''BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi. of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
DESCRIBE WORK Shorelines/ Flood Hazard Plans Required
8 ''OC ccV Wu))K 36 t)r 52 Yes❑ NotApplic. ❑ Received
VALUATION I SOURCE GAS ELECTRIC WATER SEWAGE Ownership
9 OF PUBLIC SEPTIC public ❑ Private FEES COLLECTED
UTILITIES PRIVATE ❑ SEWER El
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included o I . Q
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building
work will be compiled with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRE INSPECTIONS Plumbing
SIGNATURE OF , APPLICATION
OWNER OR AGENT DATE ' 1 —�3 Mech.
SPECIAL APPROVALS SP CIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FIN#L DATE �`��_�(,, � ^ � � � � RAW_
Plan Check
Env. Health �! V / I t`�rV `'
�/ SEPA
Planning �6
Modular/
Fire MFG. Home
Prevent.
Enoineer Other (Specify)
Utilities 1 00
TOTAL $ _..t1=/1_0
SEPA
Plans PERMIT IS NONTRANSFERABLE WHEN MACHINE VAR
IDAExam. i Y THIS BECOMES A PERMIT.
' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech. ing 7 IN 180 DAYSI' 55 _
5 li
DAT EDI —
P��-Rx�UMBER
PERMIT N�. 6' z 10 fO'FAL
u