1982, 06-22 Permit: 82A-5201 GaragePLAN NUMBER
f2' 6'LZ4
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
JOB ADDRESS
`4- � - Dr,IJ&
LOT SUBDIVISION
3ND
PHO
2a- - ►;750
BLOCK
OWNER M I� �
ADRyE�S�ASf'�0 Ni
•
CO TRACTORE srot I � �.,j.1
r
4. A 9"015 `�2 I�
DESI�NER�
5.
41
2
P 6
ray
z
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
7.oI2o�,
if
Actual Set Backs in Feet
North/ 5 (South 4-4 East 2� 1 (West I✓
Size o Parcel Zone classification
c LJ rm
itA
Tvetloist.IaOapdncy Sprinklered
❑Yes r;KNo ❑ Req'd.
6r>
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
PHONE
—1 60
v- 6
P7-2-1
Valuation
4678
Main Floor
Building Ar a in Sq. Ft.
G ag A ea Storage
Upper Floors ar g
Area of Decks
Finished Basement 1 Unfin. Basement
21 W ❑ ALT. ❑ EiM'fBLD. ❑ PLMB. ❑ MECH.
DESCRIBE WORKA
8. C�
VALUATION GAS
9.
SOURCE
OF
UTILITIES
❑ RPL. ❑ MVE.
❑ OTHER
❑ M.H. ❑ POOL
6Alrf tt.)i
ELECTRIC
WATE
SEWER
No. Baths
No. Stories
No. Rooms
-TWO
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Enum. Dist. I Location (Area)
Ownership
Public 0 Private
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 C*-7/4SIGNATURE OF APPLICAN .4041/41
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Fire Marshall
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building �G
Plumbing
.�pAech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
02* *61.00
*61:006
A *000
520:02
06.22-82
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06-22'-8 2
52:0.12 *6100
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO.
FII F COPY