1982, 10-04 Permit: 82A-9079 Garage AdditionPLAN 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
1.
2.
3.
4.
JO ADDRESS
LOT BLOCK SUBDIVISION
L,s
OWNER
ADDRESS
Lo',3 0+ ,\L-r-1
COwC
ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
PHONE 5
Z�P NE °
PARCEL NUMBER /S i 7 0 (- Frye
Actual Set Backs in Feet
�7c
North 'South v East
1West 40
ZIP
Size lcel
4 Zone Classification
x Occupancy
Typ_ . gnst.
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation 1Building Area in Sq. Ft.
ZIP
Main Floor
Upper
CHANGE OF USE FROM
6. TYPE
7. OF
WORK
TO
❑ W ❑ ALT. AD N. ❑ RPL. ❑ MVE.
AA D. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Area of Decks
Floors I G rea
Finished Baseme t
Storage
Unfin. Basement
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Notyq'd.
DESCRIBE WO K
8.
L�J
VALUATION
9.
SOURCE
OF
UTILITIES
0r fiorJ (i(a,
GAS
EL TRIC
l
Enum. Dist.
WATER
SEWER
Ownership
Public ❑ Private
ILocation (Area)
/VSE 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 APPLICATION 72_ SIGNATURE OF APPLICANT����'�'
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
PlIa\lbyarrkni.ve
SEPA Checklist
ng TecA.,n
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
ech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMI NUMBER
02* *5400
907.82
1'0 -0482
2 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
li 1,
110 -�0i -8;2 907. "95
*54002
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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