1979, 08-03 Permit: 79-1519 PoolPLAN NU' IBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1.
Jop ADDRESS
,
i /////
LOT
2. 1
BLOCK
3.
OWE ER
RESS
4//)
C RP TOR
4. ����Q
DORE,SS
SLJ DIVIS1 N //
PHONE
ZIP
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 3,ZS'7/'� - 4_5'
/..a73 /3 �.-K-2
FeAWERD5,4 ACRt-3 6 -Tit AC D
Required Set Backs in Feet
/ ,`
North / D(� South^/h'
Size of Par9e1 r
L2,. o0 x .2-/S APP
East /24 (West gr°27
Zone Classtfica Ion
/4-L--
DESIGNE
5' ADDRESS
•
ZIP
q9 z /
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
IPd0
ZIP
DWL Area I Basement Area
Garage Area I Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. 13/1'
VALUATION
D I Source
JI of
9. g(540L) D utilities
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
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
J2L
performance of construction. �LCAI'
DATE 7 "c�/— 71 SIGNATURE CEJ
GAS
SEWER
LECTRIC
WATER
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
7//7
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DAT
O F F I
APP
FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
4
Plan Check
SEPA
Mobile Home
dQ
Other (Specify) -7- /
TOTAL $ L 7
DATE
}
PERMIT NUMBER
7c _ 15 f �,
02*
*47.00
* 47.00 N
* 47.00
A *0.00 3
151.82
08-03-79
2 6,479.
a
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-03-79
15135 *47.002�