1982, 07-22 Permit: 82A-6294 PoolPLAN NUMBER a
(C1
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 ADDRESS
1.
L9:1 -
2.
O: j2.
OWNER
3.
4.
1Oe2-t.-.) L{ (o�i.
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
3
SUBDIVISION
�\J`P 4? -E K —� S L. g
PH NE
47F5-5 �a(L7 1
PARCEL NUMBER/S 441/44(O0S-
ADDRESS
lc 82G
ZIP
Actual Set Backs in Feet
North 'South 12-) East
West 2 C5
CONTRACTOR +
c.4 cum O u L' • l—cn,tAELS c �-$ i •�
DDRESS
1((i N� v.E
PHONE
c 5277'5
ZIP
Z_C) (,)
Size of Parcelrr1
h1
Le -f
5.
DESIGNER
PHONE
Type Const.
\'N
Zone Classification
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
ValuationBuilding Area in Sq. Ft.
ADDRESS
ZIP
Main Floor l Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
LJ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ E.
❑ OTHER
[414;00L
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'
DESCRIBE WORK
8. t kAn tMA vel
VALUATION
9.
SOURCE
OF
UTILITIES
mot, (Icor z�
GAS
ELECTRIC
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership
Public ❑ Private EL
/dSE CODE
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-•nd ordinances governing this
type of work will be complied with whether specified herein or not. The grantifl'g .f a permit does n presume
to give authority to violate or cancel the provisions of any other state or local aw egulating constr tion or the
performance of construction. S E REV RSE SIDE FOR REQUIRED INSPECT O
DATE OF APPLICATION
SPECIAL APPROVALS'
NAME DATE
Planning
0/
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Te
SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single
Building
Plumbing
t ch.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
- A &294-
02* *2500
*2E006
A *000 S
628.'92
07-22-82
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-2.2-82 629:4z *25.00a1-2 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
i
UL's \ M•(v \ `� t:�
SPOKANE COUNTY HEALTH DISTRICT
E. 0. PLOEGER, M. D., M.P.H., HEALTH OFFICER
N. 819 Jefferson Street
Spokane, Washington 99201
PERMIT NO A/"�—
Name
DATE�TA7c
No. A 16242
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
Address -/00:a.-YSd'
/CJ 'F02 -
Address of Proposed Site
Type of Use `/`^'�„"'Y/
Number of Bedrooms f Building Cape
Water Supply
/G0 6
Septic tank capacity
length of disposal field
y
Is basement for building planned/
Camp Capacity
(City Welt Spring). Drywell
gals Style of tank
&DO
Phone No. >'fe — J`Col,43
, xC%' L!7//e-2.040-/'02
Other
Absorption Pits
Leach Bed
it
oh Proposed hewn septic lank.
di mn n.m. 1. ga. kV. and um., Out emmme•
Pi MA
rith
nstalle
ewe ^
Impatient tope -p
lint” er serecePy are. or In
lc details.
1
0
rSt-
O
l7 Q� 34'
J
4S
Finel Insp ction Date S r Agirtni
-Old AS
1� 1
Remarks
CONTRACTOR
For Spokane County Health District