1980, 03-19 Permit: 80-2391 PoolPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS �:�
LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
2. "��Irclnc /v�iw S Dict - CAt '7�.:Z c t ,tri jd s7�[ c f het
OWNER PHONE
i!i" ,� Li swr�t�;�s�e _'r ya--y-457Z !'7 Fated
3.
ADDRESS , t Jt
(� I U
ZIP[ y o
/7 •�) L L�
Require. Set Backs in Feet P' �y
North .J� South �() , East �/ West 16 X
CONTRACTOR
PHONE 7 _
Size of Parcel
8 / /(el13,0
Zone Classification
r
4. ADDRE Sof
- / / 'ei%�L%•�
ZIP
��Z, ;7G?ll'1/'tC
,T�'ype Const.
Occupancy
I I
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
sf
Alice C-®fr
5. ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
."..
---
.. /.•T � /77 !
it '"7s'� �
'.
CHANGE OF USE FROM TO Split Entry Split L el Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK El BLD. 1:1PLMB. [jMECH: ElM.H. POOL CERTIFICATE Req'd. I Recd. Not Req'd.
of EXEMPTION
DESCRIBEWO f
8. n,iO4
VALUATIONSource GAS ELECTRIC WATER SEWER
of
9, � . D L'i G Utilities
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 regulatin nstruction or the
performance of construction.
DATE SIGNATLI
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
CI�[AL CONDITIOfNS: /
DATE OFFICIAL,��-�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Z7d
Other (Specify
TOTAL $
PERMIT NUMBER
a - z-
- y'- eo
02* *25,00
*25.00
*25.00
E *0.00
175,4
03-04=80
2 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOME.$ A PERMIT.
a-