1983, 06-29 Permit: 83A-5951 PoolPLAN NUMBER
APPLICATION/PERMIT
, 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
STREET ADDRESS
1. .42t 8 -" o N O2A —1>rz.
PARCEL NO.
'z5441 --1,t 1 k
LOT
2. 1(
BLOCK
SU�p IVISION
ea) p..) 11.1A ?c N€S
OWNER
3 Ct_AL—v w ry M -f R 5
MAILING ADDRESS
GJ 4') --Le> z12.471. rz .
PHONE
PHONE
Q�L4'l��a
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to:
North 50 -r t South l6b 'r East
4.
ONTRACTOR —�
LICENSE EXPIRES
40144
West 1 Ccz,'
Residential
Commercial ❑
Size of Parcel Zone Classification
N4 7z.; iceptz6ic tZ`(
ADDRESS
N 4 S't50 ra_e'1l�
ZIP
TyQe Const.
Occupant
rn
Spr'nklered
❑Yes 0 N ❑Req'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE .t(NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. 'POOL ❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certlfi. of Exempt.
or Variance
Required Yes❑ No
Received Yes❑ No
Number
DESCRIlit WORK
eV, rte t . Ct Ob C— "Zar›Y.;"3G
Shorelines/Flood Hazard
Yes❑ NotApplic. ❑
Plans Required ❑
Received 0
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER SEWAG
PUBLIC SEPTIC
PRIVATE ❑ SEWER 0
Ownership
Public 0 Private 0
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 type of
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
SIGNATURE OF /� o APPLICATION s
OWNER OR AGENT / ( � ` "�1 (IL DATE7—
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
11011u,
eik%
&727/
3
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify) "2.-...c• Cr)
TOTAL $ ?'S'�
rERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEYAUEI2 9 8 3 PERMITg.5. 1 z
°
*25,OOTOTAL
IMPS :IAL POOLS,
N. 5150 FREYA
SPOK.\NE, WA 9:207
”- 67,74/
COST 89-95, CIL
GALVIN /�i! friFY Rs
's.. 8 P'iY '4 R
SPoMMi 1 A
M4-• /11;$
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