1980, 12-10 Permit: 80-5800 Inspect[Mn n6140816
APPLICATION/ 1'Crims
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH E1) 400000SSON / SPOKANE, WASHINGTON 09260 / Mg) 400.31175
APPLICANT: COMPLETE NUMBERED SPACES-- PRESS HARD TO MAKE 3 COPIES
sr:m.)0RK.
BL fst+aoly
Orr /OCR so
2
3„ ADDRESS
92H -o3°7
ZIP
TRACTO
CI Di
�s�¢rRESS
Bd/LNdO
DESIGNER
S ADDRESS
Prio
LEGAL DESCRIPTION — SEE ATTACHED
PA CEL NUMEER/S/BS,14-034.,
m -v. Oars L-7 MA, 7
W yro •ov E• 4.29,3'.•, s. /1.0
Bat «
?
Actual
Nor 7'
Coes gOAn.�r�.f y
S N.RNR
I//1 x /6;4 (/I /L/
Trncona. I ,.win sown*Nr.e
Live. O. 0 Mmitt
CHANBE OP UBE PROM �TO
e.
ZIP
PHONE
ZiP
len
'{139
288
BolMing arx)n 5e. Ft.
7AR'
/4109004 :aPamant
of Eameant
T. OFn b NEW 0 ALT. 0 AD.N. 0 RP, 0 MM.
WORK 0 BLD. 0 PLMR, 0 MECH. 0 M.H. 0 POOL
0 OTHER
No.9.Me I No. 0 WIN
CERTIFICATE
of EXEMPTION
4s -fa et,
‘1;" CE
UTILITIES
GAS ELECTRIC
WATER
SEWER
SM. 01e1. 1Loutfoo IA.M1
PuW/t ▪ PO Prima
009 CODE
Na Rooms No, et Oweelee.
RwZ. 1 Rea. rot Rae.
1 hereby certify that I have reed and examined this gpplicainm and ho.,- read the "00 /l1'1 provisions included
on reeert0 tide, and know the Tame to be Poe and correct All pinworms of laws end OhloMIces governing this
type of work will be complied will *00,1,0specdnd heieln of nn1 the thawing o1 .1p.n., done not presume
to give authority to violate nI i encel pie pi os otOnl or anv +MI. Stale is thee/ law rent,. 1 onetrucbon o1 the
performance of construction. SEE REVERSE SIDE FOR REOUIREO INSPECTIONS
OATt OF APPLICATION ✓ —/A 'ijD SICNAIIIRF OI APPLICANTS_ essEI _
SPECIAL APPROVALS I SPECIAL CONDITIONS:
NAME DATE
Co Engineer
UtIlleas
fi
FEES COLLECTED
Slept. E
Emwhw MCO
Nen Chao*
SEP*
Mobilo Home
Otwr ISp.clfvl
TOTAL ,37i� O
(PERMIT NVMBER
li �--1•aQ....�1
,-3800
.3000 0
'-Rtp
OC -100.80
3 61179.
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W
SET BACKS
FINAL INSPECTION:
DATE REMARKS:
(r27( 6--,2240 9v oe
' /1_,(e C•7
)7zre