1983, 06-03 Permit: 83A-4779 Detached GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,,WASHIN,GTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB AQDRESS
1. yc�C LT01"4 13/)
LOT BLOCK2.
SU/B/D�I�VIS`IOIJ
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNER
ADDRESS
PHONE
ZI P
4.
CONTFC[OR
✓ <L
ADDR?
DESIGNER
5. ADDRESS
PHONE
ZIP
?9'o 37
PHONE
�2 3Z*7)
ZI P
PARCEL NUMBER/S
Actual Set Backs in Feet
North 6 ifs "South l
Size of Par el
5k/70
Type Const.
Occupancy
V u ion 4l
Z
East 6 (West �G
Main Floor
Upper Floors
Zone Classification
Sprriirlklered
❑Yes L7No ❑ Req'd.
Building Area in Sq. Ft.
i�D
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
LK NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N. ❑ RPL.
❑ MECH. ❑ M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. 2OX Z2
VALUATION
GK'
9. \52)C —
SOU
0
UTI L
RCE
F
ITIES
G/AJS
ELTRIC
WATER
SEWER
Enum. Dist.
ILocation (Area)
Ownership
Public ❑ Private ❑
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. SEE REVERSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION
SIGNATURE OF APPLICANT
✓moi�/
_/
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
SPECIAL CONDITIONS:
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
_gujIding Technician
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 $
!PERMIT NUMBER
Lf5-A -41q
02* *47,00
*47.006
A *0.00
477,82
06k-03-83
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'6 - 0
0 3 8'3
DATE ISSUED
477,95 *47.00°H
PERMIT NCI TOTAI
CA
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