1980, 01-10 Permit: 80A-9949 InspectOWNER
CONTRACTOR
INSPECTION RECORD
LOCATION
N S E
SET C g
TYPE OF WORK
W FINAL INSPECTION:
DATE ;f ,REMARKS:
Ccs
3-7-2s/
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
14onTr ell carr CROON 1 SPOKANE, WASHINGTON *0800 1 100*I 450.3010
APPLICANT: COMPLETE NUMBERED SPACES - PRESS 110140 TO MAKE 4 COPIES
.1Up ADDRESS
I II uI Ia
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL DUMPER/4
ADOREO NER
n '
a //53•�? �/ 1
• rdnR �I�.c-(Lii - x'�ii./
ART,OCSIONER
PHONE
f,Zar /v��=
ZIP
PHONE
Required Sal 00011* In FINI
rvorin 'South
Zotns ClcesI11M1In*t
Occupancy 110054lerae
Do.. 0 140 0Reaa.
winding Brea IA 50. M.
Basement Area
51ae 01 Parcel
ZIP
Ty. Cann.
PHONE
ADDRESS
MP
DSPL Area
CHANGE OF USE FROM
TO
Spilt Entry
ow., Area I Storage
Sp Level
Rancher
▪ 0 NEW 0 ALT. 0 AWN. 0 RPL. 0 MVS.
T. OF 0 OTHER
woo', 0 010. 0 PLMe. MECH: 0 M.H. 0 POOL
No. leatka
XX170M1 2.42., tr-14,r/.1�sr(oga t't.1,0ci E j I Z.
VALUATION nlei ICT
140. Fid, < N. Regime
T Race. pot Rao e.
CERTIFICA
of EXEMPTION
Recite.
WATER
*EWER
1 Inc ehy cur Illy that I have read end examined this application end have read the "NO'T'ICE" pruvilialla Included
On Memo side, and knout the Sema to 0e nue anti Correct. All prOVhlons 00 Iuws and allllnancu0 governing this
type of work will he complied with whether specified herein or not. The granting of .1 iter mit does not preSunte
give authority to ululate or cental the provisions of eny other slate or local law regulating const r Ctlan or the
pe
DATE /��R SIGNATURE �x%'i+a
SPECIAL APPROVALS
DEPT. RE0'D. REVD.
E ns. Health
P lrc Merman
CO. En,In.r
SEPA Checklist
SPECIAL CONDITIONS:
0:
DATE/-/'. 11' OFFICIAL:11 C4v �Ii .L ✓"`�
Roc. Room
FEES COLLECTED
SI 01 *
Sulleing
Plumbing �P
Mech. /
Plan Cheek
SEPA
Mobile Home
Other gIPKIIy)
TOTAL S % 40—
M r NUSIOSR
M X. -
OATE- BO
04e *7.00
a700 0
•7.0021
*000 8
99682
01-09-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE. - -
TH15 BECOMES A PERMIT.
01`09-60' 9949° •7;00:8.