1981, 08-03 Permit: 81A-5301 InspectKAHN
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 911 JEFFERSON / SPOKANE. WASHINGTON 99290 / 19001 459.3.05
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
A? I AODRE.SS t( els„,fs
3, 7:44/.7
AODRrea
,Ei riJD3 Aisg�a� iel�
ADDR "'
Q
/725/ _4r.6
D[sIOHER
ADDRESS
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER'S
Zlv Astro, I Sat Sachs In Peat
/abrth horror
Site or Perm
T76 f AG
e`.GKNm��o^0
zry
9za/
PHONE
VeluatWn
SPI
Over Ono .. 0
MANN. Arm In 50. Ft.
CHANGE OF USE FRO
PIP
aln now
Upper Floors
TO
T. OF /KNEW 0 ALT. 0 AWN. 0 ROL 0 POPE.
WORK 0 aLD. - 0 RIM. 01.4100. 0 M.H. 0 POOL
a VALUAi ONI `! /�
[OUgrrC[
9. UTILITIES
0 OTHER
Cl a6ri � /— wriESte�
CERTIFICATE
of EXEMPTION
[num. Dlat. !Location (Arm)
LECTRIC WATER SEWER OwTK *ip ME 0009
PabiO ❑ PHyem 01
I hereby Certify that I have reed and ekarnined this applloatien and IMP load the "NU
on f n:4 I .nvnloru int: nrleH
reverse side, and kgp4 the same to ba hue and correct. All UrovounoH of level dnn o „bm9,:m 1y1.11Ullq nIH
type of work will be complied with whether specified harem 01 lint. Thu granhnq nI n nopint duet not prutulnr
to give authority to violate or cancel the provifion1 of any other 110111 01. local law reunion,. rnnetructim, o, hlr.
per tot-monoe of eonetru0tion. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION A-.7---e44-e7 SIGNATURE OF PSI 'ANT ( 9d'
SPECIAL APPROVX.L *L CONDITIONS:
p*.. ' „.
Nhall
pinmr
Ow
p,. I ac,. PYet Rm'd.
FEES COLLECTED
SI 01 S
Building
Plumbing
Mach.
PI Ch a
SEPA
Mobile Home
Other (Seemlyl
TOTAL //1"---'f:'1
e
•1400
•1400 `r
•14008
4
•000 8
5TOOB
05 -01 —841
6479.
OWNER
INSPECTION RECORD
LOCATION
CONTRACTOR
N S E W
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE
REMARKS: