1983, 09-01 Permit: 83A-8514 Carport PLAN NUMBER - . _ APPLICATION/.PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY .r. A 5(4---'
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS II PARCEL NO.
1*
�� `p � ��0
- . 1712— it l �
vc J
LOT BLOCK Su DIVISION LEGAL DESCRIPTION:
3. OWNER IVO c,SF-D0 NI
P34_,7 J) HONE
✓��NG ADDRESS Actual Set Backs in Feet to:
MAILING ZIP /�;�
17 12 North `G ) 'South East (West
CONT AQTOR �.� LICENSE EXPIRES PHONE Size gfParcel ZoneClassi�fi do Residential 27
4. ..I "'I Ni OKI S �'`.'v� 1. 77-i�" ! IW--�C �j- C�''I"1 t Commercial❑
ADDRESS +qq Zi �p Type Cgnst._ u n y Sprinklered
ra . 1 `9 C '/ � N4— \V►fAY1 ❑Yes ❑No ❑Req'd.
DESIGNER / PHONE New�on�t."Va ation Remodeled Valuation Total Bldg.Floor Area
J. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse - * U 0
.4- * ', 2, 00Y
CHANGE OF USE FROM TO Cove�V Uncv.Deck Fin.Basement Unfin.Basement
6. * v.t `„
No.Bat No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑9.EW ❑ ALT. AD'N. ❑ RPL. ❑ MVE. i','.
7• OF ❑ OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL oCrvari.ofE Variance
Required Yes❑ No❑ Number C , - 1 -. 3
Received Yes❑ No❑
DESCRIBE WORK /� ,, �� Shorelines/Flood Hazard Plans Required . 4 7 n
8. s r:‹ cwt p�< / Yes❑ Not Applic.❑ Received
VALUATION SOURCE GAS I rELECTRIC WATER SEWAGE/ ownership FEES COLLECTED
9 OF PRIVATE SEWER p❑1 Public❑Private
UTILITIES
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 Building
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 REV RSE,SIDE FOR REOUIRED INSPECTIONS Plumbing
SIGNATURE OFAPPLICATION 4//�
OWNER OR AG' .-_�..�-.�-. _ . � z-> _ DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (
PRELIM. FINAL DATE 00\11. 1.1 c • ` I(.EE REVERSE SIDE FOR NO ICE)
.J'M SIGH` I� DT J Plan Check
Env.Health
100 SEPA
Planning Modular/
MFG.Home
Fire
Prevent. 0
Engineer Other(Specify) .W.i
LT.
Utilities
TOTAL $ �2`
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
em 4- 7,‘A PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED z 11 z
Building
IN 180 DAYS DATEOISSUED / PERMI7NU.1' 4 z * 3 2 0 0 4dAL
"7-JF
13\H