1982, 04-20 Permit: 82A-2964 GaragePLAN NUMBER
7Z 4 5'l
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.
1 I CO 11— 12'3Pc^�
LO SUBDIVISION
2,A1'("F k; 000 K
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNER
IIADDRESS6 F �[J
17- , I2'97
ZIP
PARCEL NUMBER/S } 5,3K1C14
r
Actual Set Backs in Feet
North ISouN.-35
-3(7East (7 'West
4.
CONTRACT
ADDRESS
HONE
Size of Parcel
5"X 77
Zo ssification
/C--- ,/•e;* —
ZIP
Type Cpnst.
0:1
iia n cy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuatioq 1%�
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
ei:plkEW
❑ ALT.
❑ PLMB.
DE
8. ATI: 41
VALUATION
9.
SOURCE
OF
UTILITIES
EVAD'N. 0 RPL.
❑ MECH. 0 M.H.
11
)4Z41/4r (2.—C..4
GAS ELECTRIC
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not R94'd.
2-�n1
WATER
Enum. Dist.
Location (Area)
SEWER
Ownership
Public ❑ Private
/t1SE 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 INSPECTIONS
DATE OF APPLICATION
3 rZ.
SPECIAL APPROVALS
NAME DATE
Env. He
clf110
nning
Fire Marshall
Utilities
*(q k2- 2 H Oyler;
Plans Examiner
SEPA Checklist
Buildinn�Tec icii
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$,I
PERMIT NUMBER
0.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0,4
20
B2
2 9 6, 4 .Z