1980, 06-19 Permit: 80-6012 Inspection CardINSPECTION RECORD
OWNER
LOCATION
CONTRACTOR
N S E W
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE
REMARKS:
7 s C(
UMBER
x
.aB
APPLICATION/ YCIS11111
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH fill JEFFERSON / SPOKANE, WASHINGTON 99360 / 16091.66 -0676
APPLICANT: COMPLETE NUMBERED 'PACES "P: IIARD TO MAKE 3 COPIES
ADDRESS/.
1: ADDRESS /E. gs24 {� L q
LoTrtoc``a 6vtA
i. 3 8 Emu_ Noo.En SDIDDRINA LesupwrE
RevL wT PHONE
OWNER
1 , I DRESS Ce \'.1").-
ADDRESS
a.
4-ro� E 1ST fWE
CONTRACTOR
SAMC
ADDRESS
SAMC
DESIGNER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUM0ER/S
1Bs44 -z5o3
Ca-Z.0
PHONE
ZIP
PHONE
ADDRESS
CHANGE Or USE PROM
a.
TO
Actual . a4o tk'South-50' In Feet
et 4o' Iwastso'
Size or Parcel fie Classification
Wk. 2 ( K 9(. ALT¢s_ Sues..lap..w
w CawccuP r
❑ es ❑No 0
ya^, :I Area IsA.
25oo
' I =tone.
z4 a of DWG I MG easement fit I um..
—.
TYPE r NEw ❑ ALT. ❑ AWN. ❑ RPL. ❑ MVE. ❑ OTHER
T. wORK ❑ BLO. ❑ PLMS. ❑ MECN. d M.H. ❑ POOL
�°ESCROW WORN
a• J1lN W O iAOI•U Igo
TI
SOURCl OA! [L[CTRIICII WATER SEWER
a k>. cot, TILITISS 11YTCW toes �J€ TIC
I hereby certify that I have read and examined Ihp eppllcal„III .1.1 hay. Tend Ihn "Nt:1 ICI " provhorn Included
e side, and know the seine to be true end COiiUCI A' ill fins nl In.� :, Iv•Ilnnnces pnve: :ling this
On revert !it. sl he
typo of work will be violate with whether specified f hmuln le. wanting ii .I put nut dose not presume
to give authority to violate or cancel the provisions of any nlhel slain uI local law I�Ir construction
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
°'
DATE OF APPLICATION -d t� SII'NAT URE fir APPLICA ..
0.' Hh. No.ltorl.1
l IJ
CERTIFICATE
m EXEMPTION
nu . DIM. Location (Ana)
Owe ow
Ownermlp
Public OPrwate
USE COD[
SPECIAL APPROVALS
NAME DAT
five H..I
an 9
rD i -,9d0
fir. Mar.hali
Co. Engineer
SPECIAL CONDITIONS:
OAK"—
o �wNC91
ZMAj
ro —L1�
FEES COLLECTED
BI gI
Building 4 tos :.
Plumbing
0.00.
Men Cheek
SEPA
Mobil. Hem
Other (Specify)
TOTAL i \tD0.00
(PERMIT NUMBER
02• •10001)
•10000 K
`1095
05 -29 -eo
5 6479.