1982, 07-27 Permit: 82A-6444 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. rJ 2`-115 b .t mo+u o ST
LOT BLOCK
2. CO O{
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION
' ''ii
ARKE:2 RoAt t kotiLE ACME AbD
3
OWNER
MAR-jotiffmAN-EI2
ADDRESS
PHONE
C12(S) 5529
PARCEL NUMBER/5 i'F ;t_ 0555—
J V/
N 15 t pt&yrnmoNsA
ZIP
Ci9? 1(47
Actual Set Backs in Feet
(� I
North — 'South East (90 West go
4.
CONTRACTOR
ktL PS SCi_ steAkent c,1RS
ADDRESS
)J S(0 MAViar
PHONE
`IBM zatp-i
Size of Parcel
lyo¥'7
Zone Classification
RM
ZIP
X1920-7
Type Const.
VN
Occupancy
Sprinklered
Dyes ❑No 0 Req'd.
5.
DESIGNER
SAM
PHONE
ValuationI Building Area n Sq. Ft.
n1�
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
3 cQ
Storage
CHANGE OF USE FROM
6.
TYPE rce;NW
7. OF
M.WORK BLD.
DESCRIBE WORK
8.
9.
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
O RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Reap:
Dax- fE D 6 AeAGE
VALUATION
SOURCE
OF
UTILITIES
GAS
(04 ,c224)
Enum. Dist.
Location (Area)
ELECTRIC
WATER
SEWER
SEPrl L
Ownership
Public 0 Private
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.SES REVERSE SIDE FOR REQUIRED INSPECILQ IS
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
nv Health
J�`�`J''�" #2/ 2—
Planning /
Fire Marshall
Co. Engineer
Utilities
/lila xaminer
F,)5 oN fI LC
SEPA Checklist
Building Tgcltniclan
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building "7 I
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT fit:M*1 ER
8 {-441-
02*
44 —
02* *47.00
*47.008
A *Q00 S
64432
07=27-82
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
017 =14 7''+ 12:
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
6.44;42 *47,00
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