1981, 06-03 Permit: 81A-5435 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
NI. 3.% I L / S -r
LOT BLOCK SUBDIVISIO
2.
OWNER
3 MIN NIE.
ADDRESS
Nis -
CONTRACTOR
ADDRESS
--- 4.
LEGAL DESCRIPTION — SEE ATTACHED
VAN WE -Y
F -Ly sem'
•PHONE
2—Co-532.0
PARCEL NUMBER/S 06 S 3 — 2.5-6 q
BLI. 33 ext. N. 15o'
0 12 -CHARD Aoprnot4
ZIP
9q 2-0C,
Actual Sett Backs in Feet
North 40. 'South
IEast
West 2
PHONE
Size of Parcel
t(o? K Ilo?
Zone Classification
ZIP
Type Const.
V -N
Occupancy
M -I
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valua on
1/440
(Building Area in Sq. Ft.
ZIP
Main Floor'
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
' ❑.ALT.
❑ PLMB.
O AD N.
O MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Ro4'd.
DESCRIBE WORK
8. *;UaaII �r
VALUATION
9.1i 440
Enum. Dist.
A -r TActfit9 Zo - ISTIAI Cr BLDCZ.
Location (Area)
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER
SEWER
'5£1711C..
Ownership
Public 0 Private
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included-
on
ncludedon 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 authorityto 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
DATE OF APPLICATION SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Envs•Tth
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Wechnician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single . ' $
Building 426,00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ Q2
PERMIT i44UMBER,7
02'* *25.00
*2500
*2500,5
A •*000. 8
53a1'2
.0!6-0 2-8A
2 6479,
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0�6
DATEi ISS
101!3.11Y1,811,
EDi 1;
t !,
5.435 z . * 2 5.0'O.;a -
PERMIT NO. TOTAL