1981, 06-01 Permit 81A-5363 PoolYLHIN IVUIVIt5tI(
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
rPERMIT�NWLEtER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
4.
JOB ADDRESS
E. 1G3i7 2ae v ✓s.t3E
LOT
OWNER
E,ARy
ADDRESS
IE.1tol2L
CONTRACTOR
�=�fRYlnf
ADDRESS
AVViC
DESIGNER
BLOCK
5.
ADDRESS
SUBDIVISION
L:LE42— A DITtc:3
FART �12
PHONE
CA 26t48
ZIP
(ACt 2
PHONE
ZIP
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
Size of Parcel
L55 X Z1di Lv
Type Const.
Valua
Occupancy
INL Z
?
East West
Zone Classification
h& L3t r-1 IktL9
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Storage
Unfin. Basement
TYPE
7. OF
WORK
❑ BLD.
NJ NEW ❑ ALT.
❑ PLMB.
DESCRIBE WORK
8. 6vU t nn t►n t Al }C+, Pc L
VALUATION
s ILbOC7
SOURCE
OF
UTILITIES
GAS
❑ AD'N.
E MECH.
❑ RPL. ❑ MVE.
❑ M.H. POOL
L 2.1p x‘1t1-)
ELECTRIC
WATE R
❑ OTHER
SEWER
i�r IL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
Req'd.
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 APPLICATION 4LL.k 1 f 1 1i 11 SIGNATURE OF APPLICANT
SPECIAL APPROV,41LS
/1 NAME DATE
Env. H.4al
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
(
Rec'd.
Not .Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
02* *2500
*2500
*25006
A *0.00
529,0
06.-01-81
2 6a79,
c
L
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Building chni an
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
0'6=$2=$1.
DATE ISSUED
533Z *125002
PERMIT NO. TOTAL
i
- 1
f>Llj ING, �OOL
II, OOP q�I�onS
pI `+p 0
D�
7
y8
• 0 3 17 FIzrre+ Or.
T
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