1980, 12-22 Permit: 80B-1737 Inspect4o. ADORFsa
t. -9• /S a5 BGrrtC' Ro.
Wa I bLOCI( ISUUUIVISIUN
OWNER
a LCL /►n0 N . /StfK6R
ADDRESS
APPLICATION%PI MKT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
Nonni ell JEFFERS.% / SPOKANE, WASHINGTON EOM / RPM 4063676
APPLICANT: COMPLETE NUMBERED SPACES— PRESS WARD TO MAKE 3 COPIES
�• .'Ser .BC..Prer
CONTRACTOR
4, • ADDRESS
6.
a
PEW
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL Must..
4�e-0/53
LP
QYC (�
PHONE
Aatw1 S. Ego.. 1n Feat
Neon 1,0,10
510. ar Pa.o1
Jr.
'i'om cNaman
DCSION.R
ADDRESS
ZIP
PHON
Typo Conn. «uPancv
/11.1101.
SwlnluerKI
0.1 Ono 0 Astro.
.cal Wlng AIM N SA FL
CHANCRE Or USE FROM
IP
TO
Men /near I u0Par P100rs
or Oocaa
Darya. Area
Storage
fl Baa.m.n,
T. l RW O KT. ❑AWN. 0 11PL 0 PIPE.
WORK 0.L0. `0 RMo. Cl0MECH. CJ 54.11. 0 POOL
L505IRO WORN En,� 01.,, 'Location 10..11
E. LlbQ94nNfNq 9T.o,J6
VALUATION' DRC. I OAS I ELECTRIC I WATER I SEWER O..o..,n,O use COOS
1 .` UTILITIES..w0
ere 050.51. 0I
1 h.r.by eerbly 1054 I nava ,00d Eno eaammed 0141UP1caholl 4101 ;la,0 .cad VW ..NOTICI " II.,,ldou. Included
on reverse Inde, end know the same la 1N InTe and Caret, All PrlNniom o1 law.. aril ...
ITR. of perk v 11 b. complied •with whether Speeilieo herein or non. I Re ndu•no!governing10mit
,TO 154. wadtal .io.vloi4l. di Caneel the ora111ug o / 121.1111 due. nor P1 o' ne
11'.. `. pro.ld E O1 any UIR slave w ECT b.N� nao.q comuucllGn or me
sRNoRA6rIo. of eoAVuetla6; EE/E�REVyyERSE 510E FOR REQUIRED INSPECTIO y/ /
OATS OF AintewION/01-4—QQ SIGNATURE UI 'or .Llo. 1I
W5004E, APPROYAU SPECIAL CONDlT/ON5,
NAM. DATE
❑ OTHer
P111.111.11
No. Rooms
No. 01 Dwn1Pes
CERTIFICATE
al EXEMPTION
Rao's
RECO. Tlel nor a.
no. ro.rors
FEES COLLECTED
Single i
00110154
M1umbinp
Myr. 9•_
Piers Olt.
*EPA
MA611, Horne
Olnw l5P'Rnal
TOTAL S 7,ce
L -e'
r/o
L'o• •7.0
*7.0
•000
173o
l0 -09_8,D
o 6479 .
•. prlr
..-110411
Jai
y 1
OWNER
IiiiCONTRACTOR
N S E
SET BACKS
DATE
W FINAL INSPECTI
REMARKS:
LOCATION
INSPECTION RECORD