1981, 04-17 Permit: 81A-3663 Storage BldgOwnership �/
Public I=1 Private YA
PLAN NUMBEr<
(0/
J07/1/
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
LOT
G CIO
uoSUB IVI
NER
3 OW NR//L • L-
ADDRESS
j
al 4. t..1
PHONE
ZI
9�P 7c
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S ('o _,{ – 0.2
Actual Set Backs in Feet 1
North 'South 1
"
East 1- West
4.
CONTRACT
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
PHONE
ZIP
Size of Parcel Zone Classificatjon
.c i6
Typeonst. Oflupancy
Spr)'nklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
TO
Area of Decks
Upper Floors
Building Ara in Sq. Ft.
Garage Area
Storage
Finished Basement Unfin. Basement
"NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
ikl BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
DESCRIIBB WORK i-rf
A
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
IJ
WATER
SEWER
No. Baths
CERTIFICATE
of EXEMPTION
Enum. Dist. Location (Area)
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 APPLICATION
SIGNATURE OF APPLICANT(—''lam v `
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
eJ ��7
P anninq
Fire Marshall
Co. Engineer
1�11Y,/,�
Utilities
Plan Examiner
t°i
SEPA Checklist
uildi
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
17
PERMIT NUMBER
?i A- 3 “,3
02* *17,00
*17,00
*17.006
A *0,00
365.38
04 -17 -81
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
7 1 3 6 6: 3'z. * 1'7, 0,0 –
DATE ISSUED PERMIT NO. TOTAL
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