1983, 05-23 Permit: 83A-4352 PoolNUMBER APPLICATION/PERMIT j
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. IE. '1 SCA %7 •3-:EP%3 ' N OF
v.
ADDRESS
• _6
PHONE PHONE
42.8-4-9sz
ZIP
g9 zc�
LICENSE EXPIRES PHONE
PHONE
ZIP
North 9 f) ' I South
Size of Parcel
Type Const. Occupancy
East %A West
Zone Classification Residential pf
(Z -A Commercial C
Sprinklered
❑Yes ❑No ❑Req'd.
3d Valuation Total Bldg. Floor Area
Main Floor I Upper Floors I Garage/ Storage I Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement
6.
No. Baths No. Floors No. Fin. Rooms No. Dwellings
TYPE lfd NEW ❑ALT. El AD'N. ❑RPL. El MVE.
7• OF El BLD.
OTHER
BLD. ❑ PLMB. MECH. M.H. POOL [Certifi.ofExempt. Required Yes El No Number
WORK
LOT
BLOCK
SUBDIVISION
2.
Cq
I
iNl c O i+—oev.�
Yes❑ Not Applic.❑
OWNER
VALUATION
3.
31 v%•. BAtJ�of.�
ELECTRIC
WATER
PUBLIC El
MAILING ADDRESS
Ownership
a . i oet-a..
-5
UTILITIES
CONTRACTOR
4.
SEWER
public El Private
ADDRESS
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
N, td'3al
Aa�l$an►
c
DESIGNER
v.
ADDRESS
• _6
PHONE PHONE
42.8-4-9sz
ZIP
g9 zc�
LICENSE EXPIRES PHONE
PHONE
ZIP
North 9 f) ' I South
Size of Parcel
Type Const. Occupancy
East %A West
Zone Classification Residential pf
(Z -A Commercial C
Sprinklered
❑Yes ❑No ❑Req'd.
3d Valuation Total Bldg. Floor Area
Main Floor I Upper Floors I Garage/ Storage I Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement
6.
No. Baths No. Floors No. Fin. Rooms No. Dwellings
TYPE lfd NEW ❑ALT. El AD'N. ❑RPL. El MVE.
7• OF El BLD.
OTHER
BLD. ❑ PLMB. MECH. M.H. POOL [Certifi.ofExempt. Required Yes El No Number
WORK
or Variance
Received Yes[] No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
8• �uyi+rknv�v�,,� �ppL lf�X3�-
Yes❑ Not Applic.❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC El
SEWAGE
❑
Ownership
FEES COLLECTED
9 '�
UTILITIES
PRIVATE El
SEWER
public El Private
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 au-
Building
thority 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 IN PECTIONS
Plumbing
SIGNATURE OF 2�� APPLICATION y� 3,�
OWNER OR AGENT DATE �+
Mech.
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM.
FINAL
DATE
Env. Health
N
SEPA
Modular/
Planning
MFG. Home
Fire
Prevent.
Other (Specify) ZS 00
Z5 00
Engineer
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
PERMIT NUMBER
02* *25.00
*25.Oa'6
A *000
435.1 f
05-23-83
6.479.
Building�xJ I N 180 DAYS DATE {69UED� — PERMIT W.�' z fbi
* 2 5.O O �Al
Tech.