1983, 10-31 Permit: 83B-1084 Carport, AdditionPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
2.
L T BLACK
SUBDIVISION
;pr , .
O NER
3 +5ie
M I VI oto ��✓
MAILING ADDRESS
CONACTOR Vk t
4. TR
ADDRESS
P ONEPHONE
5'I
7Ip _
PARCEL NO.
-
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North !South
East..SC)
West
LICENSE EXPIRES 1 HONE
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
ZIP
PHONE
ZIP
TO
TYPE ❑ EW E ALT. VAD' N. ❑ RPL. ❑ MVE.
7. OF J� BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
WORK
8.
9.
DES RIBEWORK
' 41 rO�G i90r
�i I/ LL IV
VALUATI N SODURCk GAS ELECTRIC
OF
UTILITIES
E OTHER
WATER
PUBLIC
PRIVATE ❑
SEWAGE
SEPTIC '_
SEWER E
Residential
Commercial C
Size i f Parcel
� �( I Zpne Classifition
x CIL TJo
Sprinklered
:Yes ❑No ❑Req'd.
Type Coast.
\IA,
Occupancy
New Cqnst.%/Valuatipn
jlh�—
Main Floor U
Remodeled Valuation
Total Bldg. Floor Area
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
in. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required
Received
Shorelines/Flood Hazard
YesE Not Ap•lic.
Ownershi p
Public C Private
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 REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
Cw
APPLICATION /0/2/��JJ
DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Iryl/��U
G�.r_ ���. (-1P\c"i<7-w AI 90 %
PERMIT IS NONTRANSFERAfsLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Yes ❑ No❑ Number
Yes No❑
Plans Required
Received
FEES COLLECTED
Building
Plumbing
Mech,
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
PERMIT NUMBER
'0
02* *26.00
*26006
A *0,00
108,32
10-31-83
6.(179,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEis$UED' 5
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