1979, 12-14 Permit: 79-9062 InspectAPPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE, WASHINGTON 90260 / 16091456-3616
APPLICANT• COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
Jon
RE
LQCTlyCISIonaIl
OWNER II � HONE
926-934«
ZiP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NU
Required Sat BerraouIn Fat
Norin sm
ions Cleanleeuo It
_576 -7,z//
PHONE
pa Comt
tenpancy
SprinMlered
OYea Oso 0 Req•d
alualton (Building Area In Sq. Ft.
ZIP
DWL Area Basement Area
Gaspe Area
Storage
CHANGE OF USE FROM
Pill Entry SP
•
Rancher
TMK 0 NEW 0 ALT. �❑/AO•N. 0 RPL. 0 SAVE.
WORN 0 OLD. 0 PLEB. .ISI MECH: 0 M.M. 0 POOL
0 OTHER
No. Bet ne No. Floors
•
Rep Room
CERTIFICATE
of EXEMPTION
A DATION 50 1110. rGA
RAS
9
ELECTRIC ,
ATER
SEWER
! I hereby 0ertify that I have read and examined this applic300ll and have read the '•NOTICE" provisions included
1 on revaraei side, and know the same to be true and correct. All provisions of I.Ws and lnances governing this
type of work will be complied with whether specified hold
herein or 1101. The granting of a 0✓I010 does not presume
. to give authority to violate or cancel the provisions of any other stateeor local rer ..arm construction or the
performance of co Eruct
..DATE /a 4.7/2i 9 SIGINACH
SPECIAL APPROVALS
DEPT.
Env. Hall
Pia
Marshall
ta Erpl
MIAMI
•-t. Zeno Maumee
SPECIAL ONDITIONS.
/ 0T P/
6 '
42.7:/,
Tr Pi irw
Reg 3. rot Reg d.
FEES COLLECTED
Single $
Building
Plumbing
Mach.
Wen Check
SEPA
Mobile H nN
Other !Specify)
riaMIT Rummers
_179— lob:(
DATE /a -43-7f
04. •1200
.1200 C,
90618
12-13-79
6479
TOTAL $ /� �� ��
WHEN MACHINE VALIDATED IN THIS SPACE.
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSEW
SET BACKS
FINAL INSPECTION:
DATE REMARKS:
42 4 4 ca th - cpULK M ,{ i OIC 01/4'
c l"e 0i! -- D �(
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