1980, 02-28 Permit: 80A-9979 InspectJOB
OOR
SS
APPLICANT
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
JEFFERSON / ;SPOKANE. WASHINGTON 99260 / 15091266-0615
NORTH 611
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
4-M
DATE
3' ADORESs
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Ii1111.1111111111111111111 11110 lare Ira
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5' ADDPEss
CHANGE OF USE FROM
6.
TYPE }(.IEW ❑ ALT. .0 AWN. ❑ PPL. PAVE.❑ OTHEP
OF - .G BLD :-O'P1.ME:- ❑ MECH: ❑ M.H. ❑ POOL
woPP
I DESCRIBE WORN ®®®
B.
ygLUHTION
gam— • and examined this application and have read f the NOTICrE'' provisionsincluded
I diver a side, and
I have to to be true and correct. All provisions o lawsandantes ver
on
g this
side, kcow not. The granting of a permitt ett presume e
60 910 authoworkrity
will be complied 196601sante
whether specified herein other state or local law regulating construction to give authority to violate or cancel the Provisions of any o
perfolIMllge of construction.
.-.. _. SIGNATURE_
CERTIFICATE
of EXEMPTION
DATE
DEPT
Env. Health
N.nnloa
Pita MutensilCo. Engine.,
Zone Clearance
..
SPECIAL APPROVAL
A
EO'D.
RECD.
SPECIAL CONDITIONS
DIgNQ1
nwE An^o eSV/veIVV.DM
FEES COLLECTED
Single S
Building
Plumbing
Met,
Plan Check
SEM
Mobile Home
Other ISpecilvi---Fe-
TOTAL S
04• •7.00.
.7.00 6
*7.0 08
E .000 S
997.89
p1-09-80
- 8 6479,
Will MACIIINL VAl 1110 I t n IN Ill IS ACI .
TATS pL1,uMLS A I.FHMIT.
INSPECTION RECORD
OWNER
LOCATION
CONTRACTOR TYPE OF WORK
NSE W FINAL INSPECTION: Z
SET BACKS
DATE
REMARKS: