1983, 05-10 Permit: 83A-3878 Pool PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY —VDEPARTMENT OF BUILDING & SAFETYaet _--3s78
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESSPARCEL NO.
_
1. 6. ) •2 (n' + 'Z7254 I — .\3
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 1- 1 T3 ,i�-�1.4
OWNER
3. C Crt C5' PAALLe PHONE PHONE'_ t 54-
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
a . %3r12. �-ro. 4c 2.IC� North GO 'South East West J
CONTRACTOR LICENSE EXPIRES PHONE ,Size o cel Zone Classification Residentialid
eit.t. 'Gbh - t,� C.-s-53.741 11l IA{ 1:2—( Commercial❑
4. ADDRESS ZIP TyppeeConst. Occupancy Sprinklered `
N, t%\ct t).1E`' a ' .3-IV Ai 2_ ❑Yes 0N ❑Req'd.
DESIGNER PHONE Nui Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. q.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. /� _
TYPE 2 NEW ❑ ALT. ❑ AD'N. ID RPL. ❑LNjVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
7 WORK LIBLD. ❑ PLMB. ❑ MECH. ❑ M.H. OOL ❑ OTHER Certifi.of Exempt. Required Yes No N mbar
or Variance Received Yes No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8•• SCA.:0.nn.on-t r'• k 4-74n=>(.... C1-(=it Yes❑ Not Applic.❑ Received El
SOURCE GAS ELECTRIC WATER SEWAGE Ownership / FEES COLLECTED
OF PUBLIC QQQ SEPTIC[[��''
i CCO UTILITIES _ PRIVATE d SEWER C1 Public CI Private
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side,and know th- s- e to be true and correct. •II provisions of laws and ordinances governing this type of Building
work will be complied w' h w ether specified herein o not. The granting of a permit does not presume to give au-
thority to violate or ca el t - provisions o - y othe tate or local law regulating construction or the performance
of construction.SEE • V SE SIDE FO- •UI' It INSPECTIONS ^ Plumbing
SIGNATURE OF f A LIGATION X 3
OWNER OR AGENT. DATE /t�� _ Mech.
SPECIAL APPROVALS SPECI' CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) tt
i Plan Check
PRELIM. FINAL DATE
Env.Health
NI 5-10 SEPA
Planning
Modular/
Fire MFG.Home )-
Prevent. a
O
Engineer Other(Specify) ZS` W
J_
Utilities S.CX) LL
TOTAL $ -
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED 7 p
Building IN 180 DAYS QS UEDl O8 3 ./ 8— PERMIT z * 2 5.0 0 COITAL
Cyt l
DATE
- ,, •i;
,N E COUNTY HEALTH DEPARTMENT J -:.:T;:42..
.._5'.*
Division of Sanitation C -7
1 127 W. Mallon Avenue -�T
Spokane I I, Washington II ? Ji5 0 5
`7
TE -•-
,TION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAG DISPO) L FACILITIES
52-1.--t-• ' /IL tfl.....-4- 4.-e....,.... i. Address._i..3.. Y.1 11 Phone No
77e_.... .._�..._ ! / .4,-5,4_a_ --- Size of Property._.-Q a/ 44 0
_-�� Other .:—.
as -) Building Capacity Camp Capacity Other --•
;rade of streets or alleys? -.r .._ Are streets graded in?
lding planned? How much excavation or fill proposed?..
(1_6...
1. 6... (C' Well, Spring).
Y cc -) gals. Style of tank....._
field L.•-r) ?C'n,..i .-A....`.<... ,,4.:1
ty area to scale. Ir. ---_-
location of: Proposed house, septic tank, p Y
rell, garage, and other out buildings.
I'
any heavy slope or swampy area or any `
!
topographic details. 17 -c T-------
_i l i
3 will be ready for G / �—
it`.e.......___.____ iv .ii
ill be ready for final inspection (that is, c.)' il
4 ° ' ' LI
PORT AND RECOMMENDATIONS:
Date-of Iiispectlo71
,
.
ter
on Percolation tests: Minutes
ation s
_ 1 _ p `