1979, 07-31 Permit: 79-1366 PoolPLAN BER
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
JOB ADDRESStes 2.'17
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
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OWNER
3. „Oz.) /0/ >c e✓'4/4 .S C
ADDRESS „)— � t'4 /5c /O c
[�
CONTRACTOR /
7 o A .S
4. ADDRESS
9lf�/H S f�1
�✓
DE( NER
/77' %rr PLter S YhL
5.
ADDRESt
z' ,pl,441.5C '`• / �^, t� Jed
—
CHANGE OF USE FROM
6.
TO
P� `. 737/
ZIP 0,6
PHONE
yob ,9 /
PARCEL NUMBER/S 2
Required Set Backs in Feet
North10 6) (South East Cri)(West
Zone Classification ,
Size of Parcels
Type Const.
/
Occupancy
PHONE
/1
299'itf
VVfuation
7$ O
DWL Area Basement Area Garage Area
prinklered
Z� f'
Eves ❑No ❑ Req'd.
Building Area.in Sq. Ft.
Split Entry
Split Level
Storage
Rancher
TYPE
7, OF
WORK
i/1 NEW ❑ ALT.
❑ PLMB.
❑ E1LD.
❑ AD'N.
❑ MECH:
❑ RPL.❑MVE.
t'J
❑ M.H. POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. sem/',?.,"7—,.
VALUATI OIV
9. � a 4:7
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 laawwre ulatin�
performance of construction.
at /77
••••7f
Pc
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
DATE
DEPT.
SIGNATU�7/
SPECIAL APPROVALS SBfCIAL CONDITIONS:
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
7/2-6/7
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE 7— i-79 OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single S
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) y
TOTAL
•IQ
PERMIT NUMBEl
7�-/3"
DATE J I/11 -Y l97 7
02* *51,00
*51.00
*51.006
A *0.00 n
107.32
07-26-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-31-79
136,62 *51.00°H
141244
4
5114
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