1980, 11-05 Permit: 80B-3140 InspectER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH B11 JEFFERSON / SPOKANE, WASHINGTON Pg36e / MOM 4663676
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
LOT
BLOCK
SUE IV 10
ow e e ]%e k/a s S
a' we REtl
/JM6N'Q w4Iii 4e/ /F, .(? Grc-
Lm` AOORtl9 / /
77727 /O�wNR,?eG/.T
DESIGNER
.Ice
PH
qa s ONE -r-Aso
9yaoa
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
PHONE
.iPa /oo
Actual 6H Basks In FM
size ser Parcel
sautn Ze1ne Classification
PHONE
TYPO Goner.
occupants Sprinkler.
OVes Owe 0 Rep'.
Valuation Building Ara In SR. Fr.
ADDRESS
CHANGE OF USE FROM 1TO
a
ZIP
Mein Floor
Upper FM00 Games Area
Storage
Area of Decks
Finished Basement
Liam. Basement
TYPE '0 NEW 0 ALT. 0 AD'N. 0 RPL 0 AVE.
7 OP
0 OTHER
WORK ❑ BLD. 0 PLM.I. 0 MECH. 0 M.H. 0 POOL
No. OHM
No. Stales
No. Roams
Na. of Dwellings
CERTIPICAT!
of EXEMPTION
[num. Dist.
DESCRIES BIT, f / 7L
a /SCRIE B J I �i•N/ 4a,.....AI.0 /.� ({MPJ /}/Mss• .a'T
VirLUATIONI SOURCE r(
0, ' UTILITIES
1 hereby certify that I have read and examined this application and have read the "Nl)l ICE" provisions Included
of
ces
reverse workside, willsd beknow the compl ed same to be with whether specified heCein in notprovisions The granlawsting and hn 11nnandoesntruing this
type onot. g u Ii•lmlt presume
this
to give authority to violate or cancel the provisions of any other slate or local law renunaung construction or the
performance of construction. SEE REVERSE SIDE FOR REOUIRED INSPECTIONS
Location tAral
OAS
¢CTRIC
WATER
SEWER
DATE OF APPLICATION SI GNnruHt r>t nl PLICANT
Ownership
Public CI Private ❑
USE CODE
Re4hd.
RaLad, diol RN'C,
SPECIAL APPROVALS
NAME GATE
m aN1+.I1R.....
igloo
Saps Examiner
SPECIAL CONDITIONS:
5nrt
FEES COLLECTED
Single $
Building
Plumbing
Mach.
o�A
P.Pla k
3 oC
y.oC
SEPA
Mobile Ham
Other ISPedif0)
TOTAL E dG
eCIS
34* .7.00
•7.0-0
.7.0.
u .000
3139°
11-04-80
8 6479.
OWNER
CONTRACTOR
INSPECTION RECORD
LOCATION
TYPE OF WOR ,
NSE W FINAL INSPECTION:
SET BACKS
s-
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