1982, 09-17 Permit: 82A-8341 Pool PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT V �� 44'1e1
VNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 0 2 * * 2'5 0 0
13 I LEGAL DESCRIPTION - SEE ATTACHED
1 LOT `BLOCK SUBDIVISION PARCEL NUMBER/S IG O
2. IZ.C^ Is ia!q r iti i
OWNER Vv -�`� it ► o (� �C
3. ' , -fin f F.,d .,( 777.04E:7;34._I
ADD12E55„.., ZIID ��, Actual Set Backs e
C• 1 '! V North 'South� East •—
IWest
CcWRACTo r � o -06"7 Size E Parcel Z Cl sie;C , ation { P'
4. ADI tEES,S., ZIP Ty� IC nst. OAryncy Sprinklered
L l ZIP Elves ❑No CI Req'd.eq'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.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. 0 AD'N. 0 RPL. ❑ M ;E.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ElMECH. ❑ M.H. ' POOL CERTIFICATE Req'd. Recd. Nq'd.
of EXEMPTION
8
DESCRIBE 1 N I� TOOL, ( -3 A K i �� Enum.Dist. I Location (Area) T
. J WI .2Ki FEES COLLECTED
V I
VALUATION SOURCE GAS ELECTRIC WA ER �SSEEyW�ER Ownership USE CODE
a CC° UTILITIES v ( �� Public ❑Private
i 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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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 INS' - , IONS Plumbing
DATE OF APPLICATION —/ SIGNATURE OF APPLICAN_' li►.:+' _Alai
� }Uh�� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Health
./ ,/, ,/ �/f 7 SEPA >
/fanning
u-I
Mobile Home -
Fire Marshall -
Co. Engineer Other (Specify)
Utilities rf z
TOTAL $ /
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
t ;y ,'+ _
li It --- - mcrtn ` PERMIT IS NONTRANSFERABLE 0 9 P1'7- -8 Z 8 3 ( 1 z * 2 5 0 0 a0 F
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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