1980, 09-08 Permit: 80-9758 Pool'LAN NUMBER I APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB A DRESS . I
G' jN LEGAL DESCRIPTION =�E ATTACHED
LOT I BLOCK'SUBDIVISION PARCEL NUMBER/S
2.
OWNER PHONE
ADDR SS f1 ZIP Actual Set Backs in Feet
—22 , North South "+ East - West
CONTR ACTOR PHO) r � Size of Parcel Z�e�assifiia>� n
4.
ADDRESS ZIP Type Const. Occupancy Sprinklered
[]Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
TYPE No. Baths No. Stories / No. Rooms No. of Dwellings
NEW ❑ ALT. ❑ AD'N. ElRPL. ❑ Mj�E.
7, OF _ / ❑OTHER Req'd. Recd. Not 'd.
WORK 1:1BLD. ElPLMB. ❑ MECH. ElM.H. POOL CERTIFICATE , fR�q
of EXEMPTION
8.
DESCRI qEI W. gR_Ff j '1,�j1( J��� Y Enum. Dist. Location (Area)
�(rrnnll / FEES COLLECTED
/VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
O F
�J — L' c u' UTILITIES 6Public ❑Private Single $
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 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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION - SIGNATURE OF APPLICANT �/1Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
tnv. rte n
Hing
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ui g i c i a n
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home -�
Other (Specify)
TOTAL
PERMIT NUMBER
02* *25.100
*25.00 N
*25.;0061
A *0.00 0
975.72
09-08-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
97 5,8.2 *25.0.0 0