1980, 08-13 Permit: 80-8463 GaragePLAN NUMBER
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
1. e' / . 3, (7'
LOT BLOCK SUBDIVI I9N
2. ,r/,c /CS
,NE. 3.A\DRE'l
f :.
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL. NUMBER/S /Q6.«^', :�--cyclo
�C 0TH z3/ -K
A P �� _ `, ,! LEY6rAT,-+`
ZIP
ZIry
1761/16/'
CONTRACTOR 7
PHONE
Actual Set Backs in Feet
(South [East -77 'West
Zone Classification
North
Size of Parcel
▪ ADDRESS 1
y"
DESIGNER
ZIP
Type Const.
�.��1'I�
Occ pancy S inklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation lry
s.
Building Area in Sp. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
aly NEW
❑ BLD.
❑ ALT.
O PLMB.
❑ AD'N.
O MECH.
❑ RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
8.
D SCRIBE WORK
VALUATION
47,3 G! L)LJ
▪ /14-.,e1 .
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER
SEWER
Enum. Dist.
Req'd.
Location (Area)
Ownership
Public ❑ Private(
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions includeu
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 /%
TE OF APPLICATION �S `�-� SIGNATURE OF APPLICANT ',/�/�✓�.'i) e /�iC G'L U
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
�C
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
4ct'h
lding Technics
� �il/'Y.teAt
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
h
W'.
-"ER IT NUM?R
02* *5600
*5600
*56006
E * 0.0 0 U
84628
08-1�-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'08H"8' 0'
DATE ISSUED
84`6,35 *56.00°�
TOTAL
PERMIT NO.
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