1981, 07-08 Permit 81A-6796 PoolIll
PLAN 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 F _ I�
LOT
4.
OWNER
AD
BLOCK SUBDIVISION
C k7c4J frciA9 7
SS ZIP
CONTRACTO
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
054,
Actual Set Backs in Feet
North 'South
Size of Parcel
ADDRESS
ZIP
Co n st.
Occup?nc
DESIGNER
ADDRESS
PHONE
ZIP
Valuation
Main Floo
East Wes
/ram
Garage Area
Z ne Classifi at on
Gk,
Spri klered
Elves ❑No ❑ Req'd.
Buildi
ng Area in S4 . Ft.
00
Upper Floors
Storage
6.
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
U NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ My E.
❑ BLD. ❑ PLMB_ ❑ MECH. ❑ M.H. ?Jr/POOL
DESCRIEil W.,2PIK
VALUATION SOURCE GAS If ELECTRIC WATER
OF
9. Soo UTILITIES
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 re lating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
❑ OTHER
No. Baths
No. Stories No. Rooms
No. of Dwellings
CERTIFICATE Req'd.
of EXEMPTION
Enum, Dist. Location (Area)
DATE OF APPLICATION
S WE
Ownership
Public ❑ Private
USE CODE
SIGNATURE OF APPLICANT''
PECIAL APPROVALS
NAME DATE
7e? rii
Pla ing
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Rec'd.
Not Re d.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify'"'=
Po)l,•
TOTAL $
i„,„,„rv.,( ,.4,JIvIo�..
5l,TT `.7!"t�
0.2* *25.00
*25.00 N
i*25.000
A *0,00
679.52
07-08-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
L
PERMIT IS NONTRANSFERABLE
oglio& IT 87'
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
6796z *25.000 -
PERMIT NO. TOTAL
M
1616
,2ZICL 7�144-1 <<a! I
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