1980, 10-08 Permit: 80B-1121 InspectPLAN rj..1MEER
`/Q— 74f
a�A. psi Plan
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OWNER •'1 e2,0 N /IMI./U/i /.�/ei��.1/i7C/
/1� u6 Y. PHONE
3' AD RESS I, �LJLCIA' 4z.'C —HoB7
ZIP
s e"r <TGR r PHONE
APPLICATION /PERMIT
9/3.01 SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 511 JEFFERSON / SPOKANE. WASHINGTON MEP / I60a) 4663676
COMPLETE NUMBERED SPACES
APPLICANT
— PRESS HARD TO
MAKE 3 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBERS /8'
,Lori ,ec/C
a. =1
DESIONER
5.
6
.OGRESS
ZIP
PHON
CHANGE OF USE FROM
ZIP
TVP. MI
7. o NEW 0 ALT. ❑Rom. ❑ RPL. ❑ MVE.
W000 0 BLO. 0 PLME. 0 MECH. 0 M.H. 0 POOL 0 OTHER
8. ;ram1
3.1 Sao
UPP.r,P RnU /MR /A An0/r,WN
.
Actual Set Backs In FM
North
I Spr th Ealln Last
SU* of Parcel :: a .L 3CC n N��
Ovn ONO 0 Roo
.
y :M�`] 0 alining qrM n Ft.
Flow Q
Uppw Floors wage Area 1 Storage
Oecks I F"'"' B.Mment
N .0 hs I No Stories I NO.R Rooms o. of Dw011Ing
CERTIFICATE IJI Reg y. 1 ,
of EXEMPTION
I I ���tLLL..III
90Uq�1 OA ELB�1 ATER SEWER
UTIlITI E6 Ownerlhlp [ COO[
NOM OPNea.IXI W
I hereby cerhly thud I hove land and examined this application end have ,ued the "NOTICE"
on rWarp aide, and know the nl.% governing ling this
type of work will be same (� el IMO anti correct. All nlpvlaluns "I tang end panedndos not ing tau
spate ietl with anther f herein 01 11 The opal law I9 a paned doll not Dreruthe
Ito Sipe authority ns violate , SEE E REVERSE the SE SIDE o1 any UI D I uI E local law IeWllxhllu �.nrlltruction or the
�PxlarinErwa of construction. SEE REVERSE 91DE FOR REQUIRED INSPECTIONS
DA rE OF APPLICATION 9—.20' -8D
— SII:NATURk Ilr APVLICq _
OFICIAL APPROVALS SPECIAL CONDITIONS:
NAM[ DATE
an
til
CoSEneines
FES COLLECTED
Single
Building 2 /��
Plumbing
Mesh.
Plan Cheek
SEPA
Mobile Hones
Other (Specify)
TOTAL S
PEW. NUMBER
&O8— 1 \21
C2* *21000
021000
' '12.10.008
•000 8
09 -26 -80
? 6479
OWNER
c
INSPECTION RECORD
CONTRACTOR
LOCATION
TYPE OF WORK
N S E W FINAL INSPECTION:
SET BACKS
DATE
REMARKS:
/D/� 6/),
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