1981, 04-16 Permit: 81A3602 Pool PLAN NUMBER ' H PERMIT DUMBER Y-
��r� si APPLICATION/PERMIT —1
/ SPOKANE COUNTY — BUILDING CODES DEPARTMENT 'I
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
e..)
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 02 * * 2500
1�1 IDL�EmY LEGAL DESCRIPTION — SEE ATTACHED
Gr00 u
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. c1 9..1 OG,E(11Cau-t fs►P TES li Z 25541 - 60c1 * 2 5. 0 0
OWNER PHONE
3. -0. 2. `5An)1Di5E2 gLef'3Dll A * 0 0 0
ADDRESS
J ZIP Actual Set Backs in Feet 1 _�
6 t ictl4- R%®LaEYlkoput C4O 1 Northf() (South East IWest�G
CONTRACTOR PHONE Size of Parcel Zone Classification 0 4- 1 6- 8 1
irtMP 2IAL POOL') 49A-5044 Iftr gt-IU AQ EJit.C- FiiNlm►L4
4' ADDRESS �ZII/P. Type Const. Occupancy Sprinklered �'4 7 9'
NC 51S6 "FiZ64,n� 4A 21J7 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Val ation Building Area in Sq. Ft.
5. t£�,Sbd &,00
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
V NEW ❑ ALT. 0 AD'N. 0 RPL. 0-1 MVE.
7 WORK OF ❑ BLD. 0 PLMB. 0 MECH. 0 M.H. LTJ POOL ❑ OTHER CERTIFICATE Req'd. Recd. Not jeq'd.
of EXEMPTION
DESCRIBE WORK / Enum. Dist. I Location (Area) '
8. 1Z itOC iill' 6 WievimildG Pc-.4i.. L Y21)> l FEES COLLECTED
,{, VALUATION, SOURCE GAS ELECTRIC WATER SEWER Ownership . / USE CODE y
yal 6i_t0.0 UTIL TIES y Public ❑Private i,CJ
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 INSPECTIONS Plumbing
DATE OF APPLICATION - /�7 - J��E� SIGNATURE OF APPLICANT' < <� ��
"Ii- �—` Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA o>-
Planning O
U
—
Mobile Home w
Fire Marshall
4
Co. Engineer Other (Specify) 2�`(::;°
Utilities TOTAL $ 75.c
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Bu'ldi g Technician PERMIT IS NONTRANSFERABLE 0'47ri�.1�6,t;''8 11 3 6 0.2.Z *2'50 0 °a
r 6 4 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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