1980, 11-10 Permit: 80B-3151 InspectIMANUrFplist
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 1111 JEFFERSON / SPOKANE, WASHINGTON 0112130 / ISOM ASASIMS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS •
/14 f Iftit • fl
3. DRESS
CO r.L.M 11.74.444-4.4..
PHoNE
fish' /NO
ZIP
99-2-66
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
Actual Mt Backs In FM
North ISouth st 'West
Size of PAM Zone ClassificatIon
A.DIRESS
DESIGNER
5. ADDRESS'.
ZIP
Tsma Con.
OccuparicY Sprinkler.
0Vas Ofgo Do.00.
PHOISE
valuation Miming Area In So. Ft.
Main Floor
UoMr Floors 1 Garage Area
Storage
CHANGE OF USE FROM ITO
7. OF
TV.. 0 NEW 0 ALT. 0 AWN. L. 0 SIVE.
N. 0 RP
.000 13.1.0. 0 PLM.. 11(1 MECH. 00.0. 0 POOL 0 0„.
0.
Area of Decks
'IMAM Basement
Ufa In. 8450111Ont
No. Baths
No. Stories No. Rooms
Mc (I. rot RmYl.
CERTIFICATE
ol EXEMPTION
Rased.
No. of Dwellings
NUR RE ,
a
VALUAT SOURCE GAS ELECTRIC WATER
9. VTlerfIES
Enum. Dist.
Lou.. (Areal
SEWER
Ownership USE CODE
Public 0 PrIvate 0
I hereby certify that I have read and examined 11.15 application dix1 ii,ve read the "NU movisions included
on Meer,. side, and know the same to be true and coireci All provisions ol laws and ,,,,pnances governing this
type of work will be complied with whether specified herein oi oxst. 'he granting mit does not presuine
to give authority to violate or cancel the provisions of any other stare ni local law • .xistructinn or the
performance of construction. SEE REVERSE SIDE FOR REOUIRED INSPECTIONS
DATE OF APPLICATION Sil ourvi_it.A
WECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
FEES COLLECTED
S'ngle
Building
Plumbing
Mock.
Plan Chock
SIPA
Mobilo Horne
Other Ilipeglfy)
TOTAL $1707 -
PERMIT NUMBER
BOO
.7.0
•70
11-0a-80
6479.
aesuwaisus List insT n TMIR a/AMC
INSPECTION RECORD
OWNER
LOCATION
CONTRACTOR
NSE W
SET BACKS
TYPE OF WORK
/ ���
FINAL INSPECTION: //-1,2---F0 /7/kW- V
DATE REMARKS: // �
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