1981, 04-23 Permit: 81A-3837 Pool PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
/ 3/V — BUILDING CODES DEPARTMENT I ja"3337
� , SPOKANE COUNTY eilm...r..
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS ri LEGAL DESCRIPTION - SEE ATTACHED r * • * `' 5 0 0
LOT BLOCK SUBDIVISION PARCEL NUMB
044*2 - 14_ 2-
2. ?-,v 2, M /fid . * 2500":
f l
OWNan]
3 1 6KPHONE
H c �, r 725- �)694— p, * 0. 0 0
ADDRESS i �. � I ZIP
Actual Set Backs inFeet /I, i¢, 3 7 6
C, 7 '''',2-4 North ISouth.2- East IC/ 'West
CONT ACTOR PHONE Sizeof Parcel Zone ssi ti 04 2
4' J� fncy ADDRESS p � ig
Sprinklered
V t II 17' Mid ,.> KoAsv Qq- `v�
Oyes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage -
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE �// No.Baths No. Stories No. Rooms No. of Dwellings
Lj� NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF i� // 0 OTHER Req'd. Recd. Not R d.
WORK rJ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. L�7 POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) FEES COLLECTED
8. =*1..JINI MI t\161 f'oaL, ( '' ..- 0 >4- 4-0) 1
VALUATION SOUR E GAS ELECTRIC WATER SEWER Ownership VUSE CODE
O
9. ` `// OO 2 UTILITIES �+ Public ❑Private Single $
I heref5y 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 presum-
to give authority to violate or cancel the provisions of any other state or local law regulating construction or
performance of construction.S E RE ERSE SIDE FOR REQUIRED INSPECTIONS / Plumbing
DATE OF APPLICATION Airff 0 SIGNATURE OF APPLIC• AL��I�/ e _ ��L e Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS-
NAME DATE GO -i' u . /LA -51— or_ LZoI ') 5Plan Check
N ILLLIII / /I7/ _ �rte&IAA) "////t?/ / SEPA
Planning (,
c_7
—
L•.!
Mobile Home -_I
Fire Marshall ,"-
Co. Engineer Other(Specify)
i
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
ing Ted/Alan PERMIT IS NONTRANSFERABLE 0 44j/,gl` '-.81 3`8'3,7'z *'2 5.0.0 a FPI
� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
ti
LEJT Z5N I`k120,Q ISL rDRDIIJC� �u pL4T 12.E.CORDC.D N
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