1982, 03-22 Permit: 80-442 InspectPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNIY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON -/ SPONANE, wASH INGTON 99350 / 15091 458.3875
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
B ADDRESS
1. S l(� BOL.I VAR. VatADKF
LD: CR SUBDIVI 1
2. /It34
3 A NEP
Z ( _lis( n
Sv
5. 1916 1'o LdVAR
LEGAL DESCRIPTION - SEE ATTACHED
RHONE
GR4—'loss
PARCEL NUMBER/5
6.
CONTRACTOR
Sq Ynk
ADDRESS
DESIGNER
ZiP cs7North
PHONE
Required set Bears In Feet
IB
sur of Parcel
ZIP
PHONE
Tvw Conn.
Veluation
Zip
OWL Area
IWest
dote Ent
Zone Classification lMuonkl
cr DV. ONo ❑ R.P.
Building Area m sae Ft.
aaamant Arse crape Area
Storage
CHANGE OF USE FROM
TO
sent Entry
Split level
Bencher
0 NEW 0 ALT.
' wC Ix BLD. 0 PLMe.fit
❑ AWN.
00001
0 RPL.
O M.H.
❑ MVE. O OTHER
0 POOL
No. Baths
No. Floor,
No. Room.
R ROOM
CERTIFICATE
I EXEMPTION
Reap. rot0.00.
DESCRIBE N
a IWscVALUATottWoo Srce ''IJP AS
g, ate.
I
ELECTRIC
WATER
SEWER
I Inio:hy certify that I have read and examined this applIcatlon and have read the "NOl ICE" ploWsions included
l
side, and know the s e to be hue and c t
ect. All provisions of laws and ordinances governing this
type ofwork will be complied with whether specified herein o lot. The granting of a Velour does notpresume
to give authotity to ructiviolate or cancel the provisions of any o[hel state or local law Iegula�hny�cu/nstrucnon or the
parformerlgE of construction.
.2 1, off K__„ L/�f'�/1tJ'!p7_ghl— �
DATFAT_7.flam/Mr• • � �I /ff., SIGNATURE /4
SPECIAL APPROVALS
DEPT. REVD. REVD.
Env. Realm
Ira Manna.
Co. Engineer
Utilities
Tone Crearane,
PA CileCkliSt
SPECIAL CONDITIONS:
FEES COLLECTED
Single S
Building
Plumbing
Mech.
Nen Cheek
SEPA
Mobile Home
Otherlspecilyl
7.00
TOTAL $ •AO
1,1,11,111 PIUNIPPCM
DATE %2/-19 `.
0 u • . 7.0 0
.700
.7.000
E •000 8
2
01-22-80
2 6479.
rte".
cl
Alla.
131
N//MM ��(y4([[�'�
E 1DATk011, IS SI'.i"t
TaH 15 {(�CpElEbit * n n , `
.7962r
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSEW
SET BACKS
DATE
FINAL INSPECTION:
REMARKS:
, 'ce, .i , (d_.L /C •c (7 4.4
t
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