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1979, 10-16 Permit: 79-6113 Pool
1'PLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS II__ 1. �� IW LOT SUBDIVISION 2. OWNER BLOCK 3. Z q' ci�-K ADDS -7910 NoF/t CONTT✓TRRACCCTT OOORR T. A ADDaEss 'Vf� PcV�j r ©. 4X 6117 vMNI6 4. 5. LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S og 544-- 03 a I PHON 26E -z45G DESIGNER ZIP Required Set _ Backs in Feet North 3t!2 ISouth2---4— // East - (West aE 11',60 Size of arcel Zone lassificatio I9 x So(L6cst11°J_ ZIP 77 2.n3 Type Const. Occupancy Spin lered Oyes ONo O Req'd. PHONE Valuation Building Area in Sq. Ft. ADDRESS ZIP DWL Area I Basement Area Garage Area Storage CHANGE OF USE FROM 6. TO Split Entry Split Level Rancher TYPE 7. OF WORK CJ NEW 0 ALT. 0 PLMB O IUD. O AD N. O MECH: O RPL. �0 MMVE. .H O M. Lyf POOL 0 OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Recd. Not Req'd. DESCRI E WORK - 8. IMMiNG, �oo� Source (I6x'4) VALUATION GAS 9. CoW I 000of Utilities 1 hereby certify that I have read and examined this application and have read the " on reverse side, and know the same to be true and correct. All provisions of laws type of work will be complied with whether specified herein or not. The granting to give authority to violate or cancel the provisions of any other state or local law ELECTRIC WATER performance of construction. DATE OZr / C, /97? SPECIAL APPROVALS - DEPT. REQ'D. REC'D- SEWER NOTICE" provisions included and ordinances governing this of a permit does not presume regglating construction or the SIGNATURE y Env. Heakh P '(-o- %i9' -i:'-7 Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL - CONDIT IONS:I I- A 012--.. DATB' 7* 7'JOFFICIAI ,(y7 t& j ///.I.L.C�i APPROVED FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home F� Other (Specify/25 ,0d root- TOTAL $ PERMIT NUMBER 7 T oil 1.5 DATE ID.6''4? 02* *250-0 *2500 *25006 8 *000 8 61082 10-16-79 a 6479. Ce O — U W 0 - WHEN WHEN MACHINE VALIDATED IN THIS SPACE, THISIBEECOMES A PESMIT. 611'13 *25.0,07,_� __..1.7y/f) I� yzsic