1980, 09-22 Permit: P803-0192 InspectionAPPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 450 -0818
APPLICANT: COMPLETE NUMBERED SPACES PRESS HARD TO MAKE 3 COPIES
6'sussomsss
• 11 /i ' ws 41 -10X'
I +. %&L l H"i=r7a3=sii
LEGAL DESCRIPTION — SEE ATTACHED
Actual Set Backe In FM
Slz• or Parcel Zona CNNlgullo
ZIP
Type con
E
DESIGNER
P ON
valuation
ADDRESS
ZIP
Me
CHANGE OF USE FRO
1L
Sprinkle.
0 Os 0R•ed
Garage Area
Storage
In. Basanwnl
TYPE �NEw
7. WP ❑ e
ORN LD.
❑/ALT. ❑ AD'N. ❑ RPL ❑ MVE.
DI PLMS. ❑ M[CH. ❑ M.H. ❑ POOL
❑ OTHER
o. eon. I No. Storms I o. Room.
a DELI F WORN
VALLUAT SOURCG II
Q UTIUTI[e
AS
ELECT IC
CERTIFICATE
of EXEMPTION
Enure. Dm e . !Lp tion (A1•
ATER
WER Owrznio USE CODE
Public 0 Priv.0 ❑
I hereby certify that I have read and examined this apphcanl n..nnl mad the NO I. ' rHov I,lons included
on reverse aide, and know the same to be true and cotteel All Iii nsIsoll s 0? laws .11111 governing this
type of work will be complied with whether specified herein ii I. 1 he granting of ;plum! does not presume
to give authority to violate Or cancel the provisions 01 a 11111 1 slPli. oi local law le0.l.n , co,10f1J0lo11 or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPSC 0
DATE OF APPLICATION/.! . ,7i!) SIGNATInr.l0 APPLICA
INCIAL APPROVAL[ tr[CIAL CONDITIONS:
NAME MT[
Env. Health
D
Fli{ M•r.hell
Cc� Engln«
an. Examin.
No. of OW0111119
FEES COLLECTED
S gl
Building
Plumbing
Pk
SEPA
Mobile biome
Other (Specify)
TOTAL S
P�15UMBER
N— �I
03+ .2550
+2550
• 2550i!
•000 S
15
09 -15 -80
3 1479.
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR
N S E W
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE
?)
REMARKS: