1979, 08-07 Permit: 79-1625 Pool PLAID NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 79 r 165
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 2 * *3 5 0 0
JOB ADDRESS *LEGAL DESCRIPTION - SEE ATTACHED 3 5 0 0 N
-I. ( � * 35000
LOT BLOCK SUBDIVISION PARCEL NUMBER/5
2 Ii5G-I — 7-I A * 0.00
OWNER PHO 1 b 2 5
Ml- JCW-7 ' � 2.
3• Required Set Backs in Feet p �7 �7
ADD ESS _ c �f'� ZIP �/)/� I / 0 8-0 ! - / 9
�, I 2 C✓t I' d';''`� North South East (West 11�
CONTRACTOR PHONE Size of Ptrcel I 1 Z ne Classifi atio 2 6 Lt�]9,
by J0i Ne 130 ,6 71 PiCIC. ,u pPu ��
4' ADDRESSZIP Type Const. Occupancy Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
E<
No.Baths No. Floors No. Rooms Rec. Room
(G
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OFICIOTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK
1=1 BLD. ❑ PLMB. ❑ MECH: 0 M.H. POOL
of EXEMPTION
DESCRI,BE WOR ' COLLECTED
8. N immit0 Fools (G rmAa
VALUATION// / of
r� Source GAS ELECTRIC WATER SEWER
9. C� 2I COO _
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 per •'t does not presume
to give authority to violate or cancel the provisions of any other state or I cal law :: in
onstruction r he Plumbing
performanceof constructtiiion.DATE 7 /jF-- 1 r SIGNATURE • -02�� T
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. ( Plan Check
Env. Health { I—
/-' ' �':;;;/',// SEPA s=
{s�f Cc / ;� u
n_
Planning — �
Mobile Home r
Fire Marshall
Co. Engineer Other (Specify)
Mal,
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. '}
DATE c` �9OFFICI` , 11 8 - 0 / _ 7 9 1 6 2,6 * 3 5, 0 .0 ° R _
APPROVED OR ISSUANCE .
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