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1983, 05-17 Permit: 83A-4154 PoolPLAN NUMBER APPL ICAT ION /PERMIT PERMIT NUMBER 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. � . . ln5-1(0 Le,00 r R z -t S`43 - 1106 LOT 2. BLOCK SUBDIV17ION LEGAL DESCRIPTION: O NER e PHONE PHONE -N MAILING ADDRESSZIP %% Actual Set Backs in Feet to: + `115 10 h_ e-26 r- N C/` G North South East West CONT TOR ✓ " I LICENSE 34E� Size of Parcel i f ZoneClassification Residential❑ 4. Kf}N — ��s .17 �3� 3. fi. Commercial ❑ ADDRESd ZIP Type Const. Occupancy Sprinkl ed /j'2;? --1O V I1 / o M-1 Dyes ❑No ❑Req'd. DESIGNER PHONE N Const. Valuation Remodeled Valuation Total Bldg. Floor Area 72r Gt 5. ADDRESS ZIP Main Floor oors Garage/Storage Greenhouse CHANGE OF USE FROM TO Cover Deck EUntk Fin. Basement Unfin. Basement 6. TYPE No. Baths No. Floors No. Fin. Rooms No. Dwellings El NEW ❑ALT. ElAD' N. El RPL. ElMVE. 7. WORK El BLD. ❑ PLMB. ElMECH. 1-1 M.H. POOL ❑OTHER Certif I. of Exempt. —7 Required Yes❑ No❑ Number or Variance Received Yes❑ No❑ DESCRIBE WORKjj Q� 8' u 1 J i Shorelines/Flood Hazard Plans Required ❑ l S 1 ,e S 1 a 4! v b a Yes ❑ Not Applic. ❑ Received ❑ VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership 9 / OF PUBLIC ❑ SEPTIC FEES COLLECTED l UTILITIES PRIVATE ❑ SEWER public ❑Private ❑ 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 `5 00y—'Z7 �Ge work will be complied 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 REQUIRED INSPECTIONS Plumbing SIGNATURE OF APPLICATION OWNER OR AGENT DATE 17 F 3 Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Plan Check Env. Health SEPA Planning Modular/ MFG. Home >_ Fire Prevent. Other (Specify) a0 c.) Engineer W 57c V J_ LL Utilities Z TOTAL $ SEPA PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. Plans Exam PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS �; — 17 — 8 3 4 1. 7, 4 o * 2 5. 0 Q o Tech ng DATE UED PERMIT N % AL I .- -- I I -A- /- -. GUY I -4 SPOKANE SWIM CENTER N. 3220 DIVISION SPOKANE, WA 99207i (5091 327 - 5223