1981, 06-29 Permit: 81A-6414 PoolNUMBER APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1-/ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. '5, 4 DC4 QtpL-,-Q 1a0 LEGAL DESCRIPTION - SEE ATTACHED
LOT 6 KUB I SON PARCEL NUMBER/S
2. -1 3 ?DNDE.tz05�A 210 f\001-rtO,-� 3-254--r��'t
OWNER
L -c N N A e7(
PHONE
(22(a -9048
Area of Decks
3. -)o4i
Unfin. Basement
ADDRESS ,�( ���� /n] y/�1
ZIP m
Q��Y�
Actual Set Backs in Feet
` 0o-1 f�, Ij
North 50 South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
I 1�R-21V'tL
No. of Dwellings
i 61; K 3C)2
iINC l� 4P"A tLq
4.
Q?; 106L.G
ADDR $S
VI
ZIP zo`7
%
Type Const.
occupancy
N•tl Z
klered
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuatl
Building Area in Sq. Ft.
5
16ob
S -76
ADDRESS
ZIP
Main FloorUpper
Floors
Garage Area
Storage
PERMIT iJUMEt'.i
f )0
47 9
CHANGE OF USE FROMTO
Area of Decks
Finished Basement
Unfin. Basement
6.
-"
Baths
No. Stories
No. Rooms
No. of Dwellings
TYPENo.
NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF � ❑ OTHER
1:1 BLD. ❑ PLMB. ❑ MECH. ❑ M.H. POOL
CERTIFICATE
Req'd.
Recd.
Not q'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
8. 'b' WtAgt1Al11111 1?00L LtoX310
Enum. Dist.
Location (Area)
FEES COLLECTED
/VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
tp['5o0
UTILOITIES
�TjL
Public ❑Private
Single $
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
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 INS IONS
Plumbing
���n—fiL�"Mech.
DATE OF APPLICATION–`� SIGNATURE OF APPLIC
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE'
Plan Check
Env. jAealth
SEPA
PI nning
Mobile Home
Fire Marshall
Other (Specify)—
Co. Engineer
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
"I P � ' � � .0 m J -
0��a;��' 8;�, 64 *25,00CEI-
Buildin Technicia
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2.2-11