1981, 06-02 Permit: 81A-5353 Storage BuildingPLAN NUMBER
1
c0:
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 A DRESS
1. � , 1709 V �I 4
LOT BLOCK SUBDIVISION II
2. I"r"e
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
3.
ADDRESS
�
1\1- 1309 1301A10l5
PHO E 1-13`'
IP
PARCEL NUMBER/S 1 � ' _ Ot 1
d 215 or V2,p32-
4.
CONTRACTOR
PHONE
Actual Set Backs in Feet
North (South I 0
Size of Parcel
East
West
Z ne Classifica ion
ADDRESS
ZIP
e C
Typpnst.
DESIGNER
5. ADDRESS
PHONE
ZIP
Valuat'on
poo
Mai Floor
Occupancy
Ik%II
Spr nklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
'3OO
Upper Floors
Garage Area
Storage
006
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
❑ ("EW ❑ ALT.
D.
0 PLMB.
DESCRIBE WORK
8. VALU TION
9.
YJ AD'N.
0 MECH.
S URCE
OF
UTILITIES
GAS
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
• AlOOrt-X1 (.V)< O`4/
ELECTRIC
WATER
EWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not eq'd.
Enum. Dist. I Location (Area)
Ownership
Public ❑Private IQ
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 re.ulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
5�4
Fire Marshall
Co. Enginee
Utilities
PIanF Examiner
Hof
27j��q�' � ,
SEPA Checklist
uildin
hn
SIGNATURE OF APPLICANT
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 $
PERMIT N,i,"„3ER
0 IA g3
C2* *29.00
* 29,00 n
* 29,006
A *0,00
52202
05-29-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
�*hilt
ilt�r Ir 8��1i
DATE ISSUED
1..r
5:31 '3`Z *,'230,0'0-1
PERMIT NO. TOTAL