1981, 08-12 Permit: 81A-8059 Garagereti,r37E,
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
1.
2.
3.
4.
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOT
A4
BLOCK
SUBDIVISION
mAD;,sAy Aco ,-11.01‘)
OWNER
Al UlZ vc.
ADDRESS t�
1204.2JGcc) I r)
PHONE
x26.5646
PARCEL NUMBER/S
.4.5"3t— C
CONTRACTOR
ZIP
ciCt z0L.
Actual Set Backs in Feet
i
North (South '4 East 1 (West
PHONE
Size of Parcel
G%D
Zone Classification
ADDRESS
DESIGNER
5' ADDRESS
ZIP
Type
Const.
..�Y
Occupancy
ES 4'061 1-i ¥th
Sprinklered
Lives ❑No ❑ Req'd.
PHONE
ZIP
Val tion
,viz
Main Floor
Building Area in Sq. Ft.
Upper Floors
�1Z
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
VNEW ❑ ALT.
Lid BLD. ❑ PLMB.
❑ AD'N.
O MECH.
O RPL.
❑ M.H.
O MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. �GTr1L�i�
# VALUATION
9F11.41.•032
�44►2A4Cac
c� A
Zq —
SOURCE GAS
OF
UTILITIES
ELECTRIC I WATER
SEWER
1 Scar,
Enum. Dist.
Location (Area)
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 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 INSPECTIO S
DATE OF APPLICATION—/2C ' Q / SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Cizuor-V
Planning
Fire Marshall
Co. Engineer
Ncrt A3 4
Utilities
Plans Examiner
-/iC�
Ch cklist
Building Technician
i
SPECIAL CONDITIONS:
•Extrlrs)(; `i+7–aV6
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building it'.00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$50.06
Arr
PERMIT °IUMBEi+
SQA- EcC11
u2* *50,00
* 5000 107)
* 50.006
A p *0,00 8
80S.8g
0'8-12-81
g 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
it t
'd+ 8''41 '�; ! 811
DATE ISSUED
805.92 *50.0o2.g
PERMIT N . TOTAL
-1)
Seco/vd
0-07
‘„0;
1
1
1
1
4;44.
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