1979, 10-01 Permit: 79-5050 Pool LAN NUMBER APPLICATION/PERMIT PERMIT NUMBER 1
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 761-505o
��-50.E D
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE `( 2-o-71
9
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
02 * * 25.00
JOB ADDRESS
E 17th$ Sk�'vl ,(J A�1� LEGAL DESCRIPTION — SEE ATTACHED * 2 5,0 0
1. LOT BLOCK SUBDIVI ION A��r�- PARCEL NUMBER/S Zpslr9�"7o7 * 25.00 U
2. ci 7 SKyvn51,U A�KfS PHONE CC77 T 77 /T p *O.O O U
OWNER U
3. 66/ °MON J NUJ_ 92-1-/-63 PO _ 5 O 4,92
ADDRESS ZIP Required Set Backs in Feet
E A 1 Ila e, sic yin A) 1 SPacisi F dl`i2O( North 643' (South 7 7 f East ii-g' lest
z 1 0-01 -7 9
CONTRACTOR PHONE Size of Parcel Zone Classification
PA1/tL i01J f OOL_S 23466- /6 575- . qo' X /SO` AGR.iGUiz-'URAL..-S.uB 2 6 a 79,
40,
4' ADDRESS // A^ n���� ZIPType
h Type Const. Occupancy Sprinklered
/f7Z W. 6 f tvEs KOPP SPOJ'Ch 4E.- R / zip, Dyes ❑No ❑ Req'd. y�
DESIGNER i PHONE V�,luation Building Area in Sq. Ft.
5-5495° 512 _
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage
-- I f
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
% / No. Baths No. Floors No. Rooms Rec. Room
TYPE CJ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ' "-'
7. OF � ❑ OTHER
WORK ❑ BLD. LIPLMB. ❑ MECH: ❑ M.H. FL 1r OL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION ./..----
DESCRIBE WORK
FEES COLLECTED
8. SW►MMINPOOL.-.
VALUATION Source GAS ELECTRIC WATER SEWER
X
of
EX LS-n/45 -
9. 'ffiS" 95'- 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 "1'25"oa
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 f construction. Plumbing
DATE q ,1-01-71
SIGNATURE _ �- Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. rtus{.� FOR. COPY OF C N IRACThRS s'LIceN rE Plan Check
Env. Health � N3 616 5/1-'g'O
Wet� � ////,>2-/./71/ SEPA I-
0
F--
Planning — w
0-
Mobile
Mobile Home 07
Fire Marshall 2.--
Co.
Co. Engineer Other (Specify)
Utilities D.
TOTAL $.-,S' �f
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist �� 7 �f THIS BECOMES A PERMIT. o * 5.0 O a j
DATE fa' I- r t OFFICIAL YID/ 6' P PP" '1 0 •- 0 �1 -7'9 5'0 5.0 z .2 U
APPROVED FOR ISSUANCE -
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