1979, 07-30 Permit: 79-1241 Pool ... rvUiVIBER IAPPLICATION/PERMIT PERMIT NUMBER
I. SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7 - )2 W
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE ,JUl \/ 30/147/
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES p
JOB�A�jDRESS 02 * * 81.00
1. ✓"' I' o4— -1A1-11;r`( LEGAL DESCRIPTION — SEE ATTACHED * 8 1.0 0 ..
LOT BLOCK SUBDIVISION PARCEL NUMBERS * 81.0 O c..)2. 33 7.Z3`- 354- . . 12. 2.
DJ{ RM . P�"-' -018& s E * aoo n
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3. � 1� � �
ADDRESS ZIP Required Set Backs in Feet 1 2 4.0 R
¢ °' 9TAN / North ISouth East &E) (WestCONTRACTOR PHONE Size of P11"—•
cel Zone Classification 0 7—3 o—7 9
HOKMAN IA Pb1�?"�� -528-176 0 2 6 4 7 9,
4'
ADDRESS
� ZIP Type Const. Occupancy Sprinklered
7 I3I HO( V NV 1 1, Oyes ❑No ❑ Req'd.
DESIGNER 1 PHONE Valuation Building Area in Sq. Ft.
J. ADDRESS ZIP DWL Area Basement Area Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MV
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. 111I(MECH: ❑ M.H. POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIB WORK
8. H✓V v r WOR.K, l'oo� FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
9. IiSoo of
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
Plumbing -
performance of constr ction. ``��
DATE SIGNATURE-444114.4a: Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health j .
t - /� !( 77/,-71`:-/-77-/ / SEPA c
Planning L
— w
0
Fire Marshall Mobile Home c.
z
6I, 00
Co. Engineer Other(Specify)I
/ V
Utilities
TOTAL $ Si xt'
Zone Clearance ti
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist C� 07 - 30 -79THIS BECOMES A PERMIT.
DATE��-�/ OFFICIAL L 4. 1 `- * 8 1. 0 0 ° F2
APPROVED FOR ISSUANCE
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COPY ONLY ' T` + 2ND HALF IRR.
DUE BY
SFO I I I
NO RECEIPT ` TOTAL
WILL BE — NOVEMBER 30
_ DELINQUENCIES AS OF
MAILED P rrn F=S MIT G YEAR AMOUNT INTEREST TOTAL NO FIRST HALF TAX
PAYMENTS AFTER
I I I DELINQUENT DATE
PLEASE SEE I
I I TAX AMOUNTS
IMPORTANT THE B NOTICE
� UNDER AMOUNTS ON THE BACK OF
THIS STATEMENT IF NAME OR ADDRESS IS INCORRECT $10.00
TO BE PAID
PLEASE PRINT IN THE CHANGE. WHEN PAYING ANY DELINQUENCY IN FULL
ASSESSMENTS CALL 456-4713 For Correct Interest.
LEGAL DESCRIPTION
r PE it5T,TYPE DIST.4TYPE PST. OWNER JA""t` B ::CKc-R ADDITIONAL
23025_43 �'T, ir' lJ� :3'41/4 UF
SE1/ 4 DDF: E'E:, 'T ti PT 30 ' W E. 145' N OF SE CDR TH N73Di: G 13MI'l N
DELINQUENCIES
INININTEREST RESTO
27SDS W25n. B6' TH N110 ' TH N57DEG 31MIN 44SDS E65 .192 ' TH CURRENT
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