1981, 05-21 Permit: 81A-5006 GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — dUILLrING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. E.121i'1 t:x)N
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER
DAi_t
PHONE
PARCEL NUMBER/S N t'(
SUNK, -rl.4 v. zcici.-C .rii. �. �I" %.4;.34.:;3(0
b?P.D-T;,t ti ) -f 14:0r-441- f 70_`a
ADDRESS
- i7 i 17 c 7f`,ir.
ZI P
Actual Set Backs in Feet
North 2,L) !South
East 4t) IWest
4.
CONTRACTOR
PHONE
Size of P/ar�c I Z.itiV/�
LW k. C
Zone Classification
ADDRESS
6 4-Zt' � (Vtk t:
ZIP
Type Const.
40
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valua on
TkiI ec t<'
Building Area in Sq. Ft.
2
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
d NEW ❑ ALT. ❑ AD'N. ❑ RPL.
BLD. ❑ PLMB. ❑ MECH. ❑ M.H.
D MVE.
❑ POOL
❑ OTHER
No. Baths No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not/1 eq'd.
DESCRIBE WORK
8. DETALPfLO
VALUATION
9.1' .t0
Enum. Dist.
Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public El 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 INSPECTIONSON
f SIGNATURE OF APPLICANT/`
DATE OF APPLICATION
SPEC6ikL APPROVALS
NAME DATE
E('Ealth
d ^Li2 W1
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
glut Z Q O.
SEPA Checklist
B ngfehamcian
SPECIAL CONDITIONS:
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
$ ?L)
PERMIT NUr 3ER
O2�+ *2800
*2800 to
*28006
A *000
500.52
05=21-81
g 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
015? 11.49, 8
DATE ISSUED PERMIT NO. TOTAL
500.6'z; *28.00a� -
fiet`iT tstI6
•c ck2I g.