1980, 02-27 Permit: 80-1550 Pool 1
`AN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 1SS
r NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRES0 2 * * 2 5 0 0
1. 6, 14- I9 LEGAL DESCRIPTION — SEE ATTACHED * 2` 0 0 N
LOT BLOCK SUBDIVISIO PARCEL NUMBER/S
2. '3- 10-rµX010_-ro�lttel�Ac� e _ ��- 2- - 2-:2-0 — * 2 F 0 0
OW h1F�RLilIN I `4 PHONE
244—.''2I2 B h * C 0 0 0
3' D-/ I I / e 1� P ( Required SetBacksin Feet 1 5 V.9
ADD ES IP
fi �1 North (South East (West CO 0 2 2! O 0
CONTRACTOR ' 4 ON Size of Parcel Zone Clssification 2 / C)
�a9L, WaI�l)0 i ts1 - 'vvo� ItAjIX- Osi NtC z 6 4 7 9,
4. ADDRESS �!P� ^ Type Const. Occupancy Sprinklered
It o. &C�Cr 1499.7! 1 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area 'Basement Area Garage Area I Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE ,�,� No. Baths No. Floors No. Rooms Rec. Room
�d NEW ❑ ALT. ❑ AD'N. ❑ RPL. DylVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ElMECH: ❑ M.H. LLL( POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
D ESC R I B'E WOR FEES COLLECTED
8. IVO C. I��c 36!—)
VALUATION Source GAS ELECTRIC WATER SEWER
81 coo ) of
9, { V v Utilities
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. Plumbing
DATE 472/2//
Fr) SIGNATURE ,..,aw p,,/_. Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
CaPfle.. LiC 'o-
0t.-vi
i -
I cr Plan Check
Env.Health
/k0 ( 2 - 17- 01) SEPA cc
I-
Planning —
w
�/� 0.
Fire Marshall i/`� �iC71lU1 Mobile Home z
Co. Engineer Other(Specify)
1 yV
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PE
RMIT.
How,' (.;‘,',•,, ,, -...: rzr - AT E�F F I C I A L P0*r* Cl/AJ�`-fl \ U2 +278 U1550 * 25, OO
APPROVED FOR ISSUANCE _
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