1979, 10-16 Permit: 79-6112 Pool PLAN NUMBER APPLICATION/PERMIT \ PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 11—&,
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE l r!" ' 7-7"
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 2 * * 2 5.0 0
JOB ADDRESS ro
1. Ib 23 , II LEGAL DESCRIPTION — SEE ATTACHED * 2 5.0 0
�/dCUD W
LOT BL CK SUB !VISION PARCEL NUMBER/SA 3 A /L_ - ()r 13 B * 2 5,0 0
2. `T * 000 C'
3.
OWNERCIkNi6 r ✓ ,,, ,..0.21)._7203
6 1 Q 9
ADDRESS ZIP Required Set Backs in Feet }�
1(0+ 2-77 \AIA I R V� North (South I I 0 East 40 Iwest29 1 0— 1 6—7 9
CONTRACTORPHO E Size of Parcel )Zonj .ssification 6479,
�.
4. ADDR S r1 I�Zy�� II 7 F�yw�,1V� ZIP 2 Type Const. Occupancy Sprinklered
1z 0, F K C3 II s�1 e " 1p5 ,PO J ❑Yes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area I 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 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF �/ ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK
0 BLD. 0 PLMB. ❑ MECH: CI M.H. IBJ` POOL
of EXEMPTION
D CIWORK� FEES COLLECTED
8. IVNMI Pcz � , 19 x,--3
VALUATION Source GAS ELECTRIC WATER SEWER
a 29
,r2 I O oO of
f
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 I' .1 law res. :ting construction or the
Plumbing
performanceyyof construction.V
DATE e'7- /6, /7.7'7 SIGNATURE d`i2 /--I Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: l
DEPT. REQ'D. REC'D. !AAI I . -ro �� ( Plan Check
Env.Health
1/
C".1_,1 +~•,_,1-- ,i,--) -//:•--- ;'t� SEPA o
I—
U
Planning w
CI-
rt Mobile Home c
—
Fire Marshall _"
2c, L
Co. Engineer Other (Specify)
r°611-
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklistn THIS BECOMES A PE(�RMIT. 2 ((��
DATFPY/L Z� FFICIAL,`� k/'c-�-(.-i -0-7,- %C.(-71:1-•‘-' 1O _a l 6 �'7 6 .� 1, 2 * ��O.l� L h
APPROVED FOR ISSUANCE —
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