1984, 01-24 Permit: 84A-674 CarportPLAN 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
)U� �-� /� )e lv NVy�Nr✓
1.
OL2i1-W RI BLOCK SU,,fDI !`�
/2.
3. ,lAryi076 PE
. i
MAILING ADDRESS
J
CONTRACTOR
4.
ADDRESS
LICENSE EXPIRES
5.
DESIGNER
ADDRESS
CHANGE OF USE FROM
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
TO
TYPE �( NEW I=1ALT. ❑ AD' N. CIRPL. ❑ MVE.
7.
,TRIOTHER
WORK
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ID POOL
PARCEL NO.
GI 55.2_
LEGAL DESCRIPTION: I
Actual Set Backs in Feet to: Fy..t rS, I
North (South a1`�� • I East V !west
Size of Parcel
Type Cont. Occupancy
N wConst. Valuation
2 .o0
in Floor
Zone Classification
Residential fg
Commercial Li
Spr'nklered
DYes flNo ❑ Req'd.
Remodeled Valuation
Upper Floors
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
Total Bldg. Floor Area
Garage/Storage
,v2`ij'lir ��f
Fin. Basement
No. Floors
Greenhouse
No. Fin. Rooms
Required Yes❑ No❑
Received Yes I- No
DESCRIBE WORK j4f
CAILP
Shorelines/Flood Hazard
Yes Not Applic.
VALUATION SOURCE GAS ELECTRIC WATER SEWA
Q C
UTETIES
PUBLIC SEPTIC
Ct
.� IES PRIVATE SEWER
Ownership
Public 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 FO UI D INSPECT NS p
SIGNATURE OF APPLICATION / 07 ST
OWNER OR AGENT- DATE +..
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
//24
SEPA
Plans
Exam.
Building
Tech.
PECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number_
Plans Required L.
Received
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
Gi
Q--
TOTAL $
PERMIT NUMBER
SQA"— &74
*2400
*24.006
*000
1. 7 3 v
01-24-84
E. 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1
DATE l ED
2 Q
PERMIT NO: 7. 4
*24.0044AL
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