1979, 09-28 Permit: 79-4927 PoolPLAN NUMBER APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE SEP—t 0. !el'7l
DESCRIBE WORK r
8 POOL — FEES COLLECTED
VALUATION S urce GAS ELECTRIC WATER SEWER
e►O of
9, Utilities
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 laws and ordinances governing this Building
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 regulating construction or the
performance of construction. Plumbing
DATE ` ' SIGNATURES- r -- Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATJ��2C"OFFICI
Plan Check
SEPA
Mobile Home
Other (Specify)
—
100
TOTAL $Z5!9A
WHEN MACHINE VALIDA7
THISJB3 COIaf EF A pETMIT.
02* *25.00
*250C 't -n-
49262 492.62
09-28-79
6,479.
SPACE..
*25.0rJ
i
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
AL DESCRIPTION — SEE ATTACHED
i.
L.lM�RIGK DtZL
LOT
BLOCK
SUBDIVISION
UMBER/S 2ci� ?— 05/1
OWNER
PHONE
IN
3
+
L O
ADDRESS
ZIPet
Backs in Feet
S. plqs
e
South East 70, West /
CONTRACTOR
PHONEcel
Zone Classification
1
32
4'
'SA Mrrm
ADDRESS
ZIP
Type Const. Occupancy
grin ered
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
3000
5.
ADDRESS
ZIP
DWL Area Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
._.._
TYPE ZrNEW
❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
No. Baths
–�
I No. Floors
No. Rooms
I Rec. Room
7,
OF
❑ BLD.
❑ PLMB. ❑ MECH: ❑ M.H.
,,.,� ❑OTHER
(SPOOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK r
8 POOL — FEES COLLECTED
VALUATION S urce GAS ELECTRIC WATER SEWER
e►O of
9, Utilities
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 laws and ordinances governing this Building
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 regulating construction or the
performance of construction. Plumbing
DATE ` ' SIGNATURES- r -- Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATJ��2C"OFFICI
Plan Check
SEPA
Mobile Home
Other (Specify)
—
100
TOTAL $Z5!9A
WHEN MACHINE VALIDA7
THISJB3 COIaf EF A pETMIT.
02* *25.00
*250C 't -n-
49262 492.62
09-28-79
6,479.
SPACE..
*25.0rJ
i