1980, 07-10 Permit: 80-6923 PoolT£:ST 400? ET adW
£0L4 124 60S
IrLMnV ratMOtn —
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 468.3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3•COPIES
QJOB ADDRESS
p
i.?. 'o BLOCK 1 I ID Jf
2 4% /
LEGAL DESCRIPTION — SEE ATTACHED
O NER
3. /%6.1;:01 ;an *I.o'�-�
�J�G/v- _ 0 -
4. `A DT ES DESIGNER
t...Ak za
5' ADDRESS
PHONE
928-5 S03
PARCEL NUMBER/5
LOT,/ 6L.1c /
/trtta Adn
ZIP
SONE
PHONE
9z8-t9e e
Actual Set Backs In Feet
North / 60 'South 9O
East 51.0' )West 20 /
511e of Pa)'cel r
S
ZIP
9920%
zIType Const, Occupancy
Zone Clesnnwtlop •
oPJ/ �n inkl
5prinklere
OVes ONo 0 Redid.
PHONE
ZIP
V luatIon
/3000
Malls Floor
Building Area In Sq. Fl.
S.2S
Up er Floor
• I Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE NEW 0 ALT.
7. OF
TO
WORK BLD. 0 PLMB.
0 AO N.
0 MECH.
0 RPL.
0 M.H.
O SAVE.
X POOL
0 OTHER
Finished Base ent J Untln. Basement
Area of Deck;
r i.r
No. BathsNo. St Dries
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Reold.
Recd.
Not Req'd.
0 SCR EWfORKo
B. V VALUATION
SOU RCE-{/Y�LYLG
VALUATION SOURCE I GAS
OF
9. UTILITIES
PM.
Enum. Dist.
Location (Ana)
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private at
USE CODE
1 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 authority to violate or cancel the provisions of any other state or local law regu ing construcor
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 7--9-'574
SIGNATURE OF APPLICANT'
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env njtn
PI nning
Fin Marshal
Co. Engineer
Utilities
Plans Examiner
A Cnack
Mtn r Ts
OMNI
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE VEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
S
Mobile Home
P00e JQQ
Other (Specify) ZS
TOTAL 02Sie-12"
�
PERMIT
6d ta?" e0 I
•
02* *2500
*250.0 >n
*25006
*00.0
6862§
07-0980
£ 6479.
WHEN MACHINE VALIDATED IN THIS SPACE.
THIS BECOMES A PERMIT.
1071y1;01t8 '0' 6913'5 *25,00.2,0
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03/12/2004 15:36 FAX 509 477 4703
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03/12/2004 15:36 FAX 509 4774703
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