1982, 11-05 Permit: 82B-0682 Enclose CarportPLAN NUMBER
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
11 -
..EGAL DESCRIPTION - SEE ATTACHED
LOT
5
OWNER
ADDRESS
CONTRACTOR
AiYv
ADDRESS
ejIRWIE
DESIGNER
BLOCK
i
SUBDIVISION
A ��... � F (_ 4
PHONE
azo• 1
PARCEL NUMBER/S
241531•`'s -&9q
ZIP
gctz ‘3
Actual Set Backs in FeetrrA (--
North 'South East
(West
5. ADDRESS
PHONE
Size of Parcel
Zone Classification
ZIP
TConst.
Occupancy
Sprinklered
Oyes ❑No ❑ Req'd.
PHONE
V luation
t 000
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
ag
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW A ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
0 OTHER
BLD. 0 PLMB. 0 MECH,❑ M.H. 0 POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Rkq'd.
DESCRIBE WORK
8. Yl7C �CnaE
CArL?c5 �-r
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
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 INSPECTIONS
DATE OF APPLICATION f(>�r S 19 „� SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
�i cT EGa' O
Utilities
Plans Examiner
NO c VEc? o
SEPA Checklist
ilding Technician
ci
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single
Building marts •if))
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ t -,O
PERMIT NUMBER
02* *20:00
*20.006
A *0.00 8
6818
11-05-82
g 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11-05-82
68.22
*20,00x!
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL