1980, 08-25 Permit: 80-9050 PoolPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WC,NK
8. Sp t dcq 1, if 4.�w lri a . r?t 1,LUATION Source GAS ELECTRIC WATER SEWER
of
g, (�`�
I,) `� 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 regulating construction or the
performance of construction.
DATE !.%( 6 SI GNATU
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
E,nnv. H�eeaalltth=��
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
S IAL CONDITIONS:
f
r� r.as d
l,ADATE �� OFFICIAL �f'V (A�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $c`
PERMIT NUMBER
�f� e
DATE
*2500
*25OOv
E * 0
a2L,
08 -GO -8U
6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS j tC01 Eq A REMIT. 1p 5, n c'
*25.0%Io
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
C
LEGAL DESCRIPTION — SEE ATTACHED
OT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
De ;7 /7 1 S
)% ' » r
PHONE
9/ z it -
3.
ADDRESS_
C y
ZIP
�
�
Required Set Backs in Feet _ (�
j
"
t c
/1 0 0' J
3 0
� 6141
North 9 South e
East � West
CONTRACTOR
PHOcN/E
Size ofJ�Parcel
Zone Classification
'J'7�;w e-
',A3
Yy/'7Lfi5
J
it) 11 X /3Ci
4'
ADDR SS
_,A'
ZIP
Type Const.
Type
Occupancy
Sprinklered
P>
_3-��3
L
�C N r� [.1Ji�
�7 7
�7aeSL� �/
•t iyl��
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
yt t
:5-76
5'
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Eptry .
Split Level
Rancher
��/
TYPE 1�1 NEW
❑ ALT. ❑ AD -N. ❑ RPL.
❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7.
OF
❑ BLD.
❑ PLMB. ❑ MECH: ❑ M.H.
OTHER
POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I X
DESCRIBE WC,NK
8. Sp t dcq 1, if 4.�w lri a . r?t 1,LUATION Source GAS ELECTRIC WATER SEWER
of
g, (�`�
I,) `� 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 regulating construction or the
performance of construction.
DATE !.%( 6 SI GNATU
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
E,nnv. H�eeaalltth=��
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
S IAL CONDITIONS:
f
r� r.as d
l,ADATE �� OFFICIAL �f'V (A�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $c`
PERMIT NUMBER
�f� e
DATE
*2500
*25OOv
E * 0
a2L,
08 -GO -8U
6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS j tC01 Eq A REMIT. 1p 5, n c'
*25.0%Io
I