1980, 07-21 Permit: 80-7551 InspectAPPUWION /PERMIT
SPOKANE COUNTY LDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE. WASHINGTON 98280 / 16081456-38)5
APPLICANT COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
. JOB NOORESS
IL T /VED R BOIoN /ES
z B 4 � II4 004,074/4
OWNER
3 AICX,G i:LvS nPIAcr /O Fs,
ADDRESS
CONTRACTOR
. /L7az S4P,.6 4
T•s�
4.
ADDRESS
/boo-
PHONE
92Z -4087
ZIP
9gcOC
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMRER/S KJa- .— /�.,/Zo9
ZIP
DESIGNER
6.
PHONE
ADDRESS
CHAN..
&
,SE FRO
TO
TYPE KNEW 0 ALT. 0 AD'N. 0 RPL. 0 PAVE.
'. woRn O. ❑ PLMB. 0 MECH. 0 M.N. 0 POOL
0 OTHER
DESCRIBE & .SiiLte/ WORK
Arc 41iiir .471FNd56o
VAL- OATIC. I SOUO'CE I� OAS ELECTRIC R SEWER
9. 11UTILITI EE ■■ 1 SEPIT/G
Actual Set Backs In Feat
tnZS' Isomn 8S' � ••■ /0' Iww, 3S '
size of Parcel
AuE 2.3'N TJ,LC Nation FA/BK'•
Type Const. I Oa5PanCe smmal
Oyes ONO 0 0 Rove.
Building Area In 59. Ft.
Valyl3s Sc8 9•16
Main (or I U P art. M
(4( ..c0 1 rF1 mat I 001 In. Baseman t
.Baths I No/SterNS N o . Dwellings
/ d
CERTIFICATE Rae'd. R•c'd. 4 •d
m EXEMPTION
anu . Did. !Loudon (Area)
I81 =_Mee
We 000
Public PrN•t• Ort
9sG
I hariDy Certify that I hays read and a*emined this application 0,111 haul; ,,..el the "NOI1 +..1
on MUM side, and know the same Iu ba true and correct. All laws and on
type of work will be complied with whether spacAied hore,n 0, 0 ii The wanting 01 a I 1
to give authority to violate or cancel the provisions 01 any ache, va ,- , local law reoula
performance 01 construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
OAT E OF APPLICATION
SPECIAL APPROVALS SAL CONDITIONS:
NAME DA
•
prnvlsions included
noes gova ng this
Oaa I1. SUMO
0, istru ' . 01 the
FEES COLLECTED
Si 5' S
euuai,w Oy/y, OD
Plumbing
Plan Check
SEPA
Mobile Helm
Other (Sp•oity)
TOTAL S_J_
(PERMIT NMISER
pW %
rl -h5
OWNER
INSPECTION RECORD
LOCATION
1 5
CONTRACTOR
N S E W
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
REMARKS:
,
OWNER
INSPECTION RECORD
LOCATION
CONTRACTOR
N S E W FINAL INSPECTION:
SET BACKS
TYPE OF WORK
DATE REMARKS:
re7;,:e,/71716/
G c / - ",e%hi