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1984, 04-05 Permit: 84A-2952 Pool
PLAN NUMBER APPL ICAT !.'011/ PERMIT PE MIT NUMBER SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY -1A NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES 1 STREETADDRESS 1501120 PARCEL NO.� 1301 30I LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION: 2. OWNER i � P ON� —� � � � PHONE SPECIAL APPROVALS SPECIAL PRELIM. FINAL DATE Env. Health �. Planning Fi re Prevent. Engineer Utilities Plans Exam 4 (SEE REVERSE SIDE FOR NOTICE) PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Plan Check SEPA Modular/ MFG. Home Ot��(speoifr) ` 2S 0.�2 TOTAL $ WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. Q"� 04 r; iSL2c DATE `iSUED PERMIT�O. / _y C;--) _j *LA( G(L(- TOTAL O C C u Li MAILING ADDRESS ZIP Actual Set Backs in Feet to: I -� North South (0 East I . West CONTRACTOR LICENSE EXPIRES PHONE Size fP�cIl Loi' Zone Classification Residential]. Commercial ❑ 4. ADDRESS ZIP Type nst Occ pancy Sprinklered ^� W ❑Yes ❑No ❑Req'd. DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area � �yy Q 5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement s. No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE )!!•NEW ❑ALT. ❑ AD' N. C1 RPL. ❑ MVE. OF 7. WORK ❑ BLD. ❑ PLMB. ❑ MECH. ClM.H. .POOL ❑OTHER Certifi.ofExempt. Required Yes No El Number or Variance Received Yes❑ No El 8 DESCRIBE WORK / I Shorelines/ Flood Hazard Plans Required ❑ �O .t©� Yes Not Applic. ❑ Received ❑ VALUATION I SOOURCE GAS ELECTRIC WATE ❑ PUBLIC9• SEPTIAGGQy Ownership FEES COLLECTED UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑ 1 hereby certify that I have read nd examined this application and have read the "NOTICE" provisions included on reverse side, and know the same to be true and correct. A provisions of laws and ordinances governing this type of work will be complied with whe er specified herein or , t. The granting of a permit does not presume to give au- Building thority to violate or cancel the rovisions of any others to or local law regulating construction or the performance of construction. SEE REV SIDE FOR REi050 IINSPECTIONS Plumbing SIGNATURE OFAPPLICATION /"— T OWNER OR AGENT DATE L' Mach. SPECIAL APPROVALS SPECIAL PRELIM. FINAL DATE Env. Health �. Planning Fi re Prevent. Engineer Utilities Plans Exam 4 (SEE REVERSE SIDE FOR NOTICE) PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Plan Check SEPA Modular/ MFG. Home Ot��(speoifr) ` 2S 0.�2 TOTAL $ WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. Q"� 04 r; iSL2c DATE `iSUED PERMIT�O. / _y C;--) _j *LA( G(L(- TOTAL O C C u Li Q C