1983, 08-24 Permit: 83A-8112 CarportPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPAATMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456.3875
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREETA a2.
1. 6- :Z 2�p, L
DRESS
LOQ
2. G
3. GSLit.si ' 4 i o/ov
MAILING ADDRESS c /� L ./ I I �I
CO
4.
SUBDIVISION
ADDRESS
BL1
X41'
KI
PARCEL NO.
z 54-2--23n-
PDQ )6S
LICENSE EXPIRES
PHONE
LEGAL DESCRIPTION:
PHONE
Actual Set Backs in Feet to:
North ISouthest
( Ea
ZIP
Size of Parcel
14.5T2t.
YIV
1"
st I W
1 Zone Classiliwtion
4 G i
Residential H
Commercial 0
DESIGNER
5. ADDRESS
PHONE
ZIP
New Const. Valuation
208C2
Main Floor
J ncY
Spr nklered
OYes ONo OReq'd.
Remode ed Valuation
Total Bldg. Floor Area
Upper Floors
Gar agg1 Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Carer Dads
Uncv. Deck 'I Fin. Basement
Unfin. Basement
TYPE ❑NEW
7. OF
WORK BLD.
❑ ALT. AD'N. ❑ RPL. ❑ MVE.
❑ PLMB. ❑ MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif i. of Exempt.
or Variance
DESCRIBE WORK
_
8. CR EWK W0p-c-r"
Shorelines/Flood Hasa d
Yes0 Not Applic.0
Number
Required YesC No❑
Received Yes D No❑
Plans Requ red
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC
PRIVATE 0
SEWAGE
SEPTIC
SEWER 0
Ownership cely
Public 0 Privet
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 au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE R VERSE SID . FOR - OUIRED INSPECTION
SIGNATURE OF
OWNER OR AGEN
APPLICATION
ATE
SPECIAL APPROVALS
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PRELIM. FINAL DATE
e)(9`<
3
SPECIAL C DITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify(
TOTAL $ 4-7 r
PERMITNUMBER
02* 147.00
*47.006
A *Q00
81 1.'1 2
08=24-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATRIR EISAUEai4 ,.8'3
PERMI$Nj.1 2 kg
*47,0.O'MAL
l�I
ifi -r oAKIAl K1 y r oI T.
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