1982, 05-21 Permit: 82A-4004 PoolPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDUESS
� - LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCII SUBDIVISION PARCEL NUMBER/S A --A— _2-
2.
3. OWNER �f/os-- PiIINE `'d� �V" • whAk
AD ESS zi P Actual Set Backs in Feet
62 1 T7 A/
,
North South
East West
COA
TpR
PHONE
Sie/of Parcel
f x ' 700W
Zo a Classification
-J
4. ADDRESS
ZIP
Typ onst.
Sprinklered
VKI
4c6pancy
2/
[--]yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation I
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area i
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE NEW 1:3 ALT. 1:1 AD'N. 1-1 RPL. ❑ MV
7, OF ❑OTHER
1:1431-D. ❑ PLMB. ❑ MECH. ❑ M. H. POOL
CERTIFICATE
Req'd.
Recd.
Not d.
WORK
of EXEMPTION
DESCR
$
BE WORK i
1 f �
Enum. Dist. Location (Area)
FEES COLLECTED
VA/L�yU/A�T/I,O
SOURCE
GAS
ELECTRIC
ATER
SEWER
Ownership
USE CODE
Cll1v
9, 100
UTILOITIES
Public ❑ Private
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 INSPECTIONS
Plumbing
Mech.
DATE OF APPLICATION
SIGNATURE OF APP LICA
SPECIAL APPROVALSI
SPECIAL CONDITIONS:
NAME DATE
Plan Check
to v. Mi.
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
--j PERMIT IS NONTRANSFERABLE
.�� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify)
TOTAL $ v
PERM:? NUMEZR ^
OM 00T-
02* *25.00
'2 C
*GJ G VO u)
*25,00
A *000 0
400.3'
05-2182
r 6.479r
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
p'5 �42+'-'s'2; 4 0 a 4'Z
DATE ISSUED PERMIT NO.
*2'5,00a-�J -
TOTAL
PAt
o -F
t
fi