1981, 09-18 Permit: 81A-9519 GarageIr -MIN IV UMUc.I<
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
JOADDRESS
1. t1 . 3roy c'o i4coo
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
LOT SUBDIVISION
2.a01\110\1�/R 0010+ �F'1" 5L� S -
a OWI'IE e;„
AD1�llIRESS
til. ? 5o . PO NI 14 00 0
G;C
itM',TO
F
4.
PHONE
92-7
PHONE
PARCEL NUMBER/5 oe
5C4 _ 02_01
Actual Set Backs in Feet //-
North 'South 2 6 (East (West
ADDRESS
ZIP
Size of Parcel Zone Classificatio
O%x I R In --M-
F .�
Typ da nst.
ocyuran cy
Sprin k le red
Oyes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation
Z -9E>0
BuildinglArea in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors Garagge Area
0
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE
7. OF
WORK
LJ NEW❑ ALT.
'BLD. 0 PLMB.
❑ AD N.
O MECH.
D RPL.
O M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIB .WOR
8. to
VALUATION
9.
SOURCE
OF
UTILITIES
GA
ELECTRIC
WATER
SEWER
4419110
Enum. Dist. I Location (Area)
Ownership
Public O Private 0
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. E REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATIO
SPECIAL APPROVALS
NAME DATE
Encltrbit
7///
Planning
Fire Marshall
Co. n ineer
a14g10.
Utilities
Plans. Examiner
SEPA Checklist
• SIGNATURE OF APPLICAN
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 $ 430,
PERMIT NUIVRI72R
$114 -615 ici
02* *3800
*3800 1.3
*38006
A *000
94378
094-16-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
t) &''' I'
0'9011' Pall
DATE ISSUED
9'519 Z
PERMIT NO.
a.
TOTAL
b
C
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Th
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PARC !L. " C2( 3z/ -e,2! Z
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