1981, 06-10 Permit: 81A-5787 GaragePLAN NUMBER
1-13/4- 28/
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. N,t411,
LOT
d'I
OWNER
BLOCK
I�U2t?
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
2.
3.
tB -7-n/t69
PHONE
PARCEL NUMBER/S i fj i ZR IS LtT7
3u&I Mit111ELL15'a�C
)P.841- 170-)"
ADDRESS
LACtak
ZIP
Ret z.0
Actual Set Backs in Feet
North �, 'South East 'West
4.
5.
CONTRACTOR
5iA1ME
ADDRESS
DESIGNER
PHONE
Size of Parcel .
1cNBK t34
Zone Classification
AG,Sur3ue�AJ
ZIP
Type Const.
PHONE
ADDRESS
ZIP
Valuion
F
Occu ancy
�Iz
Sprinklered
❑Ves ❑No ❑ Req'd.
Building Area in Sq. Ft.
MainFloor
Upper Floors Garage Area
432.
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
3a+ coueeco
Finished Basement
Unf In. Basement
TYPE
7. OF
WORK
IM/NEW ❑ ALT. L7 AD N.
El BLD. 0 PLMB. 0 MECH.
O RPL.
O M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. o ?Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. AiltcrlCQ & Ava,c1C 93/ ''Z(✓Ta Wi4V
Enum. Dist.
Location (Area)
VALUATION
g. 3,585
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Serrit
Ownership
Public 0 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 -sume
to give authority to violate or cancel the provisions of any other state or local law re'..ting const cti6 or the
performance of construction. SE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
SPECIAL APPROVA
NAME DATE
cal th
:O.LG-22-10
Planning •
/00/d'/
Fire Marshall
C/9�, Englne, r
l:5 rttbcasict-' -SOP
Utilities
PI Ex finer.
o . ecv c, rte-„
A ec<list ✓�
Bylltlin7echn iy'{'"
SIGNATURE OF APPLICA
ECIAL CONDITIONS:
W1/40- ?twat) Nccet
"'Cc
PERMITISNONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
ngle $
Building 144,eci
S'
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ TI'•tO
PERMIT'NUMJIER
i 5781
'0241 *4-4:0,0
*440.0
*440,08
A *Q00 .8
5.17.'4.i
,0;*• 2 8,= 8;1
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED Y-8111
57&7 z *'4k 0;0.2.0 –
PERMIT NO. TOTAL
J-
0-
C.]
-
U
J
LL