1980, 12-12 Permit: 80B-4826 Inspection CardADDRESS
INSPECTION RECORD
DATE REMARKS
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SPOKANE COUNTY — BUJ
NoRrH all
SHINGTON
APPLICANT- COMPLETE NUMBERED SPACES — PRESS H. i 0 TO MAKE 3 COPIES
xv ADOREss
85� yki rF Rte) (r N
—tdr E_OLI. auB talon
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1 • DV7171 \�P r1iL"44\1 ` -8"787
ZIP
Aog -.054 A 1
E
ADDRESS
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LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBERS 185
4 -23Da
ZIP
Actual .cx B In FM
North lSOAt
Sias or Parcel
1 So
74 � OM teo w
nw
IWM 10
�o/R
ICNI�
•o.« oNO a
DESIGNER
S . ADDRESS
PHONE
3Z,r7c.)
BuiidInI SR. Ft.
0 4
Eip
PPE Floor.
B.t.BB Arm Shzatio
CHANGE OF USE FROM ITO
a
TYPE
7 WORK
VELD.
0 ALT.
❑ PLMe.
0 AWN. 0 RPL. 0 PAVE.
0 MECH. 0 M.H. 0 PooL
0 OTHER
AMA of Daces I Finished
i...mem Unnn. basement
No. eat. 1 No. St lot I No. a oom Ina. or Dw.ninoe
o
II I .cid. r",' •
DESCRIBE WORK I0.
• VAL A 1O[Nq�" SOURCE S ELECTRIC
�. IVTILITI[!
CERTIFICATE
of Dist. EXEMPTION
u . Dist.
'Loutlon (Areal
[n
um.
WATER
S[W
US[
PublOic rN DP,IP N CODE .t. 4
I hsnby certify that I have read and examined this application end have lead the .N!), ncluded
Si reverse Side, and know the o bet a and c ect All provisions of laws and nr.n , es governing this
type of work will be complied swith Whether specified herein Ti riot. The granting or .. iii does not pl esunse
to give authority to violate or cancel the provISIOnS of any other state Or local law lag, ,ostruction of ire
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
• IPECIAL APPROVALS
NAME DATE
S14NATURL UL APPLICANT
Nv2 pT l r
R�IC ilkx ylh tF1^+J /rNr�.
�fritre t'r ,,nr r J K co1�11'I`(GL Z 450
Aecersdrf�—{/ r�, pp>uZ .
FEES COLLECTED
Singl
B uilding —1 ▪ I
Plumbing
Mach.
Plan Check
S IPA
Mobil. Hom.
OMISir_pecitv. 14
TO L S08
02• •8800
• 8800
UPctf
12 -12 -8A
: 6479
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