1979, 12-18 Permit: 79-9190 Inspect07.N—NUMBS
APPLICATION7PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 9BT60 / 16091458-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
JOB ADDRESS
• WAS.
OWNE11111
3 Ott . a. d L • TIP
ADORES
CONTRA
Com. /A
4. gDORESS 7OOR e
DESIGNER
5. AOORE
PHONE
is
ZIP
PARCEL NUMBERS
Size of Parcel
Zone Classification
1+ 8
PHONE
Valuation
Sprinkler.
❑yea ❑No 0
Building Area In Se. Ft.
ZIP
Ba a ent Area
CHANGE O
USE FROM
Spilt Entry
Ga ago Area
Spat Level
StoNae
No Roo s
Rancher
Rec. Room
GrE•772g190
DATE —3b X71 ----I
TYPE ❑ BYALT. 0 AWN. ❑RPL. ❑MVS. ❑OTHER ®®"� CERTIFICATE
%. WORK ❑ l p. 0 PLM { r<ati. ❑ M.H. 0 POOL of EXEMPTION
FEES COLLECTED
DESCRIBE W•R�t '
& Y. ._t—L qts WgtER SEWER
VALVA ION • Sour ✓
9. Gt8(tl.8
EMI
1 hereby certify that I have lead and enanineu this application an0 'Live lead the "NU 11t'E" provisions r included
and know the sate to be 11 and correct. All in iivlatons of laws and 111 .10.15 governing onreverse side, t .I tannin does not presume
type ive authority
well be Coate or once whe pIOOhet inionsspecitof helem in ntat The granting i t. o the
p. Sive authority n violate or cancel the prov intuits of any Whin state or; el law I.• Ilul cons
pelf0l mance o1 COOSLfuctlOn.
SIGNA Si IIO ___I — -
DATE _ 1-313-7-R_____
SPECIAL CONDIT
Env. Heel.
SPECIAL APPROVALS
REO'D.
EPA C es st
Sing,. 8
Building
Plumbing
Mech. ZA--�
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL S L -e&
U4• .'200
•1200
"12006 ,
"000 8
9149M
12-17-79
2 6479.
WHEN MACHINE VALIDA I Eft IN l Ins DPA,
EH'S BECOMES A PERIN I
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W
SET BACKS
FINAL INSPECTION:
(111
•.-. iiiLei
ca ates - 'ft -o ( rY 2 (`S kAA