1983, 07-29 Permit: 83A-7150 Pool HeaterPLAN NUMBER APPL ICAT ION /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
STREETADDRESS PARCEL NO.
1. [ , 70 Aivecnparco,
LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3 L -.i- : t--5
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
•� �� �4T0��
�a7-�/�
North South East
West
CONTRACTOR
r�
LICENSE EXPIRES
PFIOj�EQ 75
/fit
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4. ti L
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
05.0j --t t 6 VcrG.A-CL1.CZ-
QK;L_. 7
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
�J.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE V�NEW El ALT.D'N. ❑RPL. ❑ MVE.
❑OTHER
�tECH.
WORK E3 BLD. ❑ PLMB. ElM.H. ElPOOL
Certifi. of Exempt.
Required
Yes❑ NOD
Number
or Variance
Received
Yes ❑ No ❑
IORK
Shorelines/ Flood Hazard
Plans Required ❑
8 _UESCRIBE�
G� { 1'75
Yes❑ Not Applic. ❑
Received ❑
VALUATION I SOOUFCE
GAS
ELECTRIC
PUBLIC ElSEPT
CWATER G❑
Ownership
FEES COLLECTED
9• UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
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 to give au-
Building
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 REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
�� Z �
1�=�
OWNER OR AGENT
DATE Iff
Mach.
SPECIAL APPROVALS
SP IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
--Y'�t��eNC� �Zt
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG.Home
Engineer
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. I I IPERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building �� IN 180 DAYS
Other (Specify)
PERMIT NUMBER
X34 -Z l_::�O
TOTAL $ -
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. 11
DATEVSSUEDC 9 - 8' / PERMITMQ 5, 0 5
* 19, 0 0 WW1PAL
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