1983, 06-13 Permit: 83A-5187 PoolPLAN NUMBER
rlJ
APPLICATION/PERMIT
:SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 458-3875
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. S. 13612.. 1-4 549.0-r)
LOT
OWNER
-Z Z
3. t14 5c1-IPtrpex-.
2.
BLOCK
PARCEL NO. 0 354 — 3502_
SURDIVISION
MBLINI';D J- I
PHON
9� SI i'S
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs In Feet to:
North ISouth 10
East 10 I Well
4.
CONTRACTOR
GL 5fo*� rcoL-S
ADDRESS
LICENSE EXPIRES
51.246. 5272
P920 Co
situ90)c 1 12 -
Type VIA
5.
DESIGNER
PHONE
occha
2
New Collet. Valuation
Zone - o IR Ion
Wr'r Art
Residential.'
Commercial 0
Spr nklered
OVes ONo OReq'd.
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fln. Basement
Unfin. Basement
TYPE .f✓j NEW ❑ ALT. ❑ AD' N.
7. OF 0 BLD. 0 PLMB. 0 MECH.
WORN
0 RPL.
0 M.H.
MVE.
S POOL
0 OTHER
NO. Bathe
No. Floors
No. Fin. Rooms
No Dwellings
Certif1 of Exempt.
or Variance
Required VesO No0
Received Yes0 No0
Number
8. DESCRIg E WORK
IAI I IV I4I N6.1 raoL
VALUATION� SOURCE
�/
9. I0 ✓WUTILLIITIES
GAS
Shorelines/ Flood Haze d
Yes: Not Apollo.❑
Plans Requ red
Received 0
ELECTRIC
WATER
PUBLIC
PRIVATE 0
SEWAG /
SEP71O0''[[JJ
SEWER 0
Ownership
Public 0 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-
thorlty 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
SIGNATURE OF
OWNER OR AGENT
APPLICATION Co 3
DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. L DATE
Env. Health
Planning
Fire
Resent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
64)
PERMIT 15 NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Nodular/
MFG. Home
Other(Specify)
TOTAL $
PERMIT NUMBER
02* *2500
*25,00
A *0.00 3
51802
06-13-83
6479.
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• 1l�;j ^� , x.
9;4;DATEED.L 3,-8 3'2
PERMI(f. "' / z * 2 l' a O
T}JfoI AL
.ye.
garage and other out bui i!�C:
heavy slope or swampy area or an
pagr aphtc details.
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For Spokane County Health Distract