1981, 10-28 Permit: 81B-1240 CarportPLAN NUMBER .
APPLICATIQ.NiPERMIT
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
LEGAL DESCRIPTION - SEE ATTACHED
2.
3.
4.
LOT
BLOCK
SUBDIVISION
5.
OWNER
. poL1D0 E.S
PHONE
PARCEL NUMBER/S 02CI.4,P -f AVc.:r IAQ0•
•6G05.4:3 — z5b5
ADDRESS
N• 3CO3`2.!_e,
CONTRACTOR
SikmC
ADDRESS
SAMC
DESIGNER
ZIP
�ill:�'C�Il2_
Actual Set Backs in Feet
North B (South (East 4 t ZS'
West
PHONE
Size of Parcel
14 .'X'S x 168.1
Zone Classification
A‘•(...1M•
ZIP
Type Const.
Occupancy�
111n-1
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Val ation. Building Area in Sq. Ft.
4P11. X528$
ADDRESS
ZIP
Main Floor
Upper Floors .Garege-irrEa Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
BE EW 0 ALT.
LD. 0 PLMB.
❑ AD'N. 0 RPL. ❑ MVE.
❑ MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Notzi''d.
DESCRIBE WORK
s. DeTw,c,t4j
VALUATION
9.41;1-s2
Cia -r U 1o5u 3 2.1( 7.4)
Enum. Dist. I Location (Area)
SOU RCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership .
Public ❑ Private Nei
USE CODE
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 autholty 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 INSPETfON
DATE OF APPLICATION't: /® -W6 —er/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
Nom 2-edo-
SEPA Checklist
Building Technician
Dialp catj 7Grvia
SPECIAL CONDITIONS:
SAW tax/mon' or CC. ?CPOL CAV 127T P4.14W
LaGYiTEA V 14l2+ru4 Ek tah V
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
,$
Building).rO • CV
Plumbing
Mech.
Plan Check
SEPA'
Mobile Home
Other (Specify)
TOTAL
$ 2,6. do
PERMIT ryUMBER
Si F'S T a -9-o
0:2* *20.00
*20,00
*20000
A *0.00
1- t'1Z
1.0 -28-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'4s;o �R1,8''':8111.
DATE ISSUED PERMIT NO.
12'4'0 1. *2 .0.-0 0:2:
TOTAL
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uJ
—J
7111 040 tv...
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