1981, 08-05 Permit App: 81A-7803 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 ADDRESS
1.
5.2425 Likaey tX.
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
OWNER
3. &Clot
ADDRESS
5.242.5
BLOCK
3
SUBDIVISION
CAIL( ?AR EsT M t 4
PHONE
ZIP
�tGl Za d
4.
CONTRACTOR�
LW] LLS G11n •TciiLC,
ADDRESS
N _ wet ?truce
PHONE
42f'5Z7Ct
PARCEL NUMBER/S
21s+2 -34a
Actual Set Backs in Feet
North (South 3Gr
Size of Parcel
ZIP
C1�t 2 t
Type Const.
Occupancy
5.
DESIGNER
PHONE
Valu ion
ADDRESS
ZIP
Main Floor
Upper Floors
East ZD' (West
Zone Classification
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area Storage
CHANGE OF USE FROM
6.
TO
Area of Decks I Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
IJ NEW ❑ ALT. ❑ AD N. ❑ RPL.❑MVE.
❑ BLD. ❑ PLMB. ❑ MECH. 0 M.H. R(
POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
R
eq'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. ; I LrtAj lvr TOGA.
VALUATION GAS
9 tR Ic
SOURCE
OF
UTILITIES
Enum. Dist, I Location (Area)
ELECTRIC
WATER
SEWER
sePrLc
Ownership
Public 0 Private
USE 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 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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLIt,ATION
SIGNATURE OF APPLICANT i.�� `P
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
•Picice-ri aisle
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
dinlechnician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify 7S .C.`+
TOTAL $ Z ,oc
PERMI4,NUMBER
02* *2'500
*2500 N
*25006
A *000
78022
08-05-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED PERMIT NO. TOTAL
7 8 ID * 2 5 0,0 a- g-