1981, 03-30 Permit: 81A-2873 PoolPLP
/1
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / 1509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1.
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LgwGl'
t?iyNE R
4.
l
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fa•/yR//} i7—», «'? 7%ActGila/P
CONTRACTOR
!'r € r &Pt,— 117-.6 ;!
ADDRESS n
—7/, !// 9 .P% 4 /Cd / f 4—ztt O'(C 4 t 1 L
DESIGNER
5.
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
asss
ZIP
0'37
ONE
ii -S.2 7 9
PARCEL NUMBERS 4.6679/-2-76-•
¢.OT r ace( SOOTH ADAtts APC
Actual Set Backs in Feet
'
North ..10n 'south � 4.� East v 7t / Lest .21n, r
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
6prmklerod
❑Yes LINO 0 Reg•d.
PHONE
V.yyatloti1
7�6n--
ADDRESS
ZIP
Main Floor
Building Area in Se. Ft.
r/ ^� / PM/.
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Docks
Finished Basement
Un/in. Basement
7.
TYPE
OF
WORK
21 NEW
0 BLD.
0 ALT.
❑ PLMB.
O AD N.
O MECH.
❑ RPL.
O M.H.
0 MVE.
4 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Reg'd.
Re '0. of Reg'd.
O€SCRIBE WORK ..
. 4.1„.• 12o -t C/ x -Q')
SOURCE rII GAS ELECTRIC
UTILLIITIESI
8. /i ct.-/A
�/b VALUATION
�• 7 v Q ?
WATER
Enum. Dist.
Location (Area)
SEWER
Ownership
Public ❑Private ja
USE CODE
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
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION .3 - •3 --g/
SPECIAL APPROVALS
Env. Health
NAME DATE
Planning
a' KR,,l it 33°
ire Marsha
Co. Eng;neer
Utilities
Plans Examiner
SEPA Checklist
Bwmin• Te hni r
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT 1S NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
PDOL -1 PU
3
Other (Specify)•
1...-
}
s
TOTAL $ ��..�
PERM'. . f.d8E1, -
2>1/4 - X7
1
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.
'3,34 2&732 *25.o vine -
DATE ISSUED
PERMIT NO. TOTAL