1981, 11-06 Permit: 81B-1569 GaragePLAN NUMBER APPLICATION/PERMIT PERM. i' NUMP
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
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK ISUBDIVISION PARCEL NUMBER/S
OWNER IPHONE
. u
3. —
ACDRRES
ZIP
Actual Set Backs in Feet (,//_
Cl
North South East
West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZIP
Type nst.
Occupancy
Sprinklered
I
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
p
5.
'<
ADDRESS
ZIP
Main FI or
Upper Floors
Gar geAtiea
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
I
,_,,%
No. Baths
No. Stories
No. Rooms
No. of Dwellir
TYPE EW 1:1ALT. ElAD'N. ElRPL. ❑ MVE.
N
DIE'S
7 1-1 OTHER
Req'd.
Recd.
Not ReA'
WORK "� 8LD. ElPLMB. ElMECH. ElM.H. 1:1 POOL
CERTIFICATE
of EXEMPTION
!
DESCRIBE WORK`
Enum. Dist.
Location (Area)
(V^7t�a j+`01-1�- �
8 �, x
FEES COLLECTED
VALUATION
SOURCE
GAS ELECTRIC
WATER
SEWER
Ownership USE CODE
9.
OF
UTILITIES
% (,
Public C1 Private
Single $
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
-3 25
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
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
Plumbing
4
DATE OF APPLICATION o/' SIGNATURE OF APPLICAN
Mech.
SPECIAL APPROVALS
r / NAME DATE
//ealth
r"LC �� ✓ /
ning
Co Engineer
o -'f I" 6<,> 10 ,
F'lam, nen r , In
SPECIAL CONDITIONS:
ng Te PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ S�
1566 M
1 1 -06-£31
6.4 9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 �1'
-G 6 -8 1 156, 9 z
*38.00CZ0- -
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f e Ic (I/ e, 5
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