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1980, 08-19 Permit: 80-8296 Inspecta.o ftazolt INSPECTION RECORD OWNER LOCATION CONTRACTOR N S E W SET BACKS TYPE OF WORK FINAL INSPECTION: /A - -J Pieta- DATE REMARKS:` /J--1 d d MaR NUM9IIR 8/9/8v APPLICATION /PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH el l JEFFERSON / SPOKANE, WASHINGTON eepso / MOW 4565075 APPLICANT: COMPLETE NUM JOS ADDRESS DD S ACES — PRESS HARD TO MAKE 3 COPIES UMW A.Ait'Nf-POIMLIIMI111111 • 1 RESS DEfWINER PHONE ZIP PHONE LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMsER/S / 7d — j<s SLUT SL ,Cd.iXL S. or Pycal / 3'. /08 Type Co.. OwPWRICy prinMNrW ❑Vet ONO 0 Rep,. Valuation sonoinp Arm / In S0. Ft. Area SN ste P. main Upper pa / 70' Arm of Decks FP... Enema. Unfln. Basement AD ZIP .CNANO[ OF USE FROM TO I E. 'VP. 0 NSW 0 ALT. JR AWN. 0 RPL. 0 AWE. T WOnH 0 BLO. 0 PI-ME. 0 M[CH. 0 M.N. 0 POOL — y O�ACRR •S,W�11 N fOURC[ GA "TRIG UT�TI 9. 0 OTHER o. No, S o. Roo ma No of Dwelllne CERTIFICATE of EXEMPTION [num. DIR. !Location (A.1 WATER I SEWER Own•rMle Ufa CODS Public 0 Private IX I Rm'd. I hereby certify that I have reed end examined thle application and have lead the "NOTICE" provisions included on ravens std, and know the same to be true and correct. All provisions of laws end oidinances governing this type of work will be compiled with whether spwifled herein of COL. The granting of a pMmlt does not presume to give authority to violets or oencei the provisions of any other alto or local law re ng construction or the performincs of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS i DATE • OF APPLICATION O� -T—�d SIONATURE OF APPLICANT %�iI�Vlew4y SPECIAL APPROVALS NAME DATE Env, Health WannIn. afr/ Co. Erwin. Ltmdm ts. U ECIAL CONDITIOFMI 7.e- .014.44.4.-, RP c E MR. d. FEES COLLECTED SIMla s B[IMIng e{eir Numbing Mach. Plan Check SEPA Mobile Home Other (Specify) TOTAL sib_ 02. 8295d 08 —b8 .-80 0 6679. •2650 •2650 •26508 '•000 5