1982, 04-12 Permit: 82A-2690 GaragePLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
ivr
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
7S L tA,9 1
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER 3. 1* r4,1't
ADD ESS
0.'
CO TRjC OR
4. All ElSi2-01 C1+51
DESIGNER
PHONE
PARCEL NUMBER /S 0 75 40 a I
Actual Set Backs in Feet
North 'South
East 'West
PHONE
5
5' ADDRESS
6.
CHANGE OF USE FROM
TYPE
7. OF
WORK
ZIP
9° c7
PHONE
Size of Parcel
T y pv/In st.
Zon Classification
-0(t:. v,
Occypancy
ZIP
TO
EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
gel LD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
8. � � I> Z,4_
VALUAT ON SOURCE GAS
OF
9. UTILITIES
ELECTRIC
❑ OTHER
VJ 0
WATER SEWER
Valuation
Main loot p per Floors
Area of Decks
No. Baths
Sprinklered
ales ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
III5
Finished Basement
Storage
Unfin. Basement
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum, Dist. I Location (Area)
Ownership
Public ❑ Private g
/i1SE CODE
Req'd.
1 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 42"-- 1r-"8
SPECIAL APPROVALS
NAME DATE
n ealth
Planning
Fire Marshall
C Engineer
&ties
Plans Examiner
dN fti_cg
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Recd.
Not
FEES COLLECTED
Single $ /�
Building `v"
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $�
PERMIT NUMBER
cP2A -2,690
02* *61,00
*61.00
*61.006
A ' *0,00
211.0'2
03- 230.82
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0;4 —4,2 =8 2
DATE ISSUED
269,02 *61.00a.E-
PERMIT NO. TOTAL
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1.
I
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15-261--ilt\161
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