1981, 04-21 Permit: M80B-4192 InspectnkrWIWISS
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 871 JEFFERSON / SPOKANE, WASHINGTON 00260 / 1600) 46 6.3878
JOB ADDR
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
4 I. Lot BLOCK fw urvI61oN
• OWNER
a �- .MORE. U j9-
S.
DGNTRACTp .Xa P
• ADDRESS �J
F, 9 io 9�
DESIGNER
• ADDRESS
6.
CHANGE OF USE FROM ITO
PHON
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
ZIP
ZIP
4ZQ �p
PHONE
Actual Set Backs In FON
North of Perm 'South `East Lest
II Zone CNN111.110R on
71,1,4 Cong. I GuuplinoY
VaMation
SONnNl
Oyes ONO 0 Rm'a
same. Arm In S0. Ft.
ZIP
eln Floor
UPmr Pious
OareM Area
torage
TYPE ew 0 ALT. 0 AD'S. 0 RPL 0 FIVE.
T WORK 0 et.o. 0 PLMB. R MECH. 0 M.H. 0 POOL 0 OTHER
DESCRIBE WORK
a Lv k'It mJ'lx., a
VALUATaJ ODURC OAS
9•
uT unfs
I,T.S
EI,EFTRIC
S12
1-1
ATER
EKWER
Arm of Decks FinIR1ao FUN 1m t I Unfln. BeNmant
No. Baths I No. Stories No Rooms I of Dwellings
Rep d. I Pet d. rot R.M.
CERTIFICATE
of EXEMPTION I
Enum, Dlel. r I Location lArml
n•rmlP
Puollc OPH.. ❑
1 hereby certify that I have lead 0,10 examined this application and have lead the 'NO1 JCL Inovlaions included
on reverse aide, and know the same 10 be true and correct. All PI uvisiolls of laws 0110 eminences governing this
type of work will be complied with whether specified heroin or 11ot, The granting 01 a 1111111)1 does not presume
to give authority to violate or cancel the provisions el any other sl.ne in local law regu1:,III1g 1;nnstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
d 1
DATE OF 0PPLICA IION • ^�' /— SIGNATURE OF APPLICANT _12,1414../71t_ l _
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
USE COOK
nv. Heann
In
arshe
Engineer
Iles
an Eaamina
FEES COLLECTED
Building
Plumbing
Each.
Nan Check
SEPA
Mobile Hone
Other (Specify)
TOTAL f ( r
NUMBER
pi !PERMIT S -�t9z
04. •9.00!.
•900y
•9004
A •000 E
419.12
11 -25 -80
64.74
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR
N S E W
SET BACKS
/ i
TYPE OF WORK
FINAL INSPECTION: .2 -� 1 �
'T (2iti
DATE REMARKS:
1( 115 / � � 1,