1980, 12-16 Permit: 80B-4935 Pool PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER. rI
Ia�/6�g� SPOKANE COUNTY — BUILDING CODES DEPARTMENT -.I<''1
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
v APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 0 2 * * 2 5 0 0
1. 1 I I 2 22-do LEGAL DESCRIPTION - SEE ATTACHED
/�
LOT BLOCK SUBDIVISION r2L ."4jL (.�T j PARCEL NUMBER/S * 2 5 0 0
2. 13 I 1 6YL or Lill '111 Kd 10 i.i,14 Tori 2- '5 LI-. 1 W I 2 5 0 0
OWNER
P\ 1� I"IA o PHONE
3 -7369- A * O.0 0
ADQRESSI I� � -K� Z7®lig 6 NorthSouth Actual Set Back' in eet
lEast 'West
CO ,N„TittACTOR FgE Size of Parcel Zope_Classification 1 2-- 1 5-8 0
4' ADDRk ESS 12-9 1 4 M � v It , I'd - ZIP,7��� Type onst. 04c'pancY SprinOyes ❑No klered❑ Req'd. z 7
9.
DESIGNER PHONE Valuation Building,Ar a in Sq. Ft.
',,((�r45 1
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage -
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE No.Baths No. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK 0 BLD. 0 PLMB. 0 MECH. 0 M.H. Ea<OL CERTIFICATE Req'd. Rec'd. No 'd.
of EXEMPTION
DESCRIBEWORK Enum. Dist. I Location (Area) '
� ,_ N N.11\161 root, C o>‹, I ) FEES COLLECTED
8. v'W I [ ,
VALLUATIQN SOURCE GAS ELECTRIC WATER SEWER� Ownership ,//USE CODE
9. / I UTIOF
LLITIES h<7. ' I,(.0� Public D Private CJ 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 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 INSPECTION , Plumbing
DATE OF APPLICATION l"'<40e' SIGNATURE OF APPLICANT /` 7-'�` i� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE �,� Plan Check
Env.V;r
141 -rJ &,,&c� yr0„�1
PlanningcD
-
,,
Mobile Home 1
Fire Marshall '-'
L.L.
I/
Co. Engineer Other�(Specify)�.7, ' ✓_
POCA1
Utilities _
TOTAL $ ..7--'
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
-Bdilding Tei• ' an — i PERMIT IS NONTRANSFERABLE •1,.21+, , i8 1' 4 9 .15 z� *2 5,0 0 2 0�� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
a -V-",q
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THE STRONGEST NAME IN POOLS
WEST 12914 MEADOWVIEW LANE
14 NINE MILE FALLS, WASH. 99026
Telephone — A/C 509 / 466-5457
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