1980, 12-30 Permit: 80B-4472 InspectNDM0ER
APPLICATION /PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE. WASHINGTON 69260 / (6061 4663675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
a
ADO LSSSS/ Y
L OT I .LOCK I U 61VIE /�L✓/,2-
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ADD /
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DESIGNER
5. ADDRESS
00000E Or USE PROM ITO
Q
?zye�'
ZIP .
PHONE
Tyra
`42.40l
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/•
Actual Set Back. In FM
16eutn tw7R
Size of Par. Zom CMWINAtI.n
6Prinklree
Dvn DN. 0 Road.
Romaine Area In SO. Ft.
ZIP
Upper Floors
Aral of DOLL I FInINad IBarmanl
Guam Arne
torso*
Untie. Basement
o• iliPN6W 0 ALT. 0 AWN. 0 RPL. 0 MVE.
7. 0 OLD. 0 PLASM .ZMECH. 0 M.H. 0 POOL
0,000
0 OTHER
VA/lA//N !� P t ff/s //ELECTR I C WATER RJ
ON S ,(/ 6
B. I&TIES Ie
PGrAo/
EWER
B.Nt I No. SIMMS NO. Rooms o. of Dwelllnee
CERTIFICATE noted. I Rr l d. Plot Feted.
of EXEMPTION
Enure. DM. !LOOM. (MM)
USE cone
OwnefshM
Peer 0Pnvale 0
I hereby certity that I have read and examined this application and have lead the "NO?' u. L 1 included
reverse on side, and know the same to be Due and c 1. All piovlsions of law, :� .nllineneesr governing this
NIA PI work will be complied with whether specified herein or not The granting of n nownit does not presume
to give authority 10 NNOlat. Or cancel the provisrpns nI dny other state or local law ra00lnt.inl construction or the
performance of constructionn./. SEE REVERSE SIDE FOR REOUIRED INSPECTIONS �a�E.
yr
DATE OF APPLICATION�6c =r� SIUNATURE OF APPLICANT ���-1EM /1
SPECIAL APPROVALS SPECIAL CONDITIONS:
.tCau,/ G/w. /e /Ccz7T/
NAME DATE
Ire Mmsh6
`P.Otrvfy
FEES COLLECTED
"
0irMl S
Building
Numbing
/z "`¢
Plan Check
BEPA
memos Nome
•1500
•1500 'r
•15008
•000 8
•
INSPECTION RECORD
j
OWNER
LOCATION
CONTRACTOR
N S E W
SET BACKS
TYPE OF,WOR
17�/
FINAL INSPECTION:
DATE
2
REMARKS: / �L
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