1980, 03-11 Permit: 80-816 InspectIIrrtRs
AN
APPLICATION/ PEKMI 1
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH ell JEFFERSON / SPOKANE, WASHINGTON .280 / 1609i 488.3876
APPLICANT COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOU ADDRESS
55 ,�i• "!`
LOT
BLOLK lUBDIVISION
Izo/aa
LEGAL DESCRIPTION - SEE ATTACHED
ow1�NAi�t7 c.• I.IANAI'KI.l-E
ADS 6 I.I9• kcecb
coNr X11)
A' ADORE. ^'
PHONE
�22 -0295
9 0 G
PARCEL NUMB
if .2C-
In Pew
Required Set Backs Louth Eine. Classification
e
Me
HONE
Parcel
ZIP
Ty. Cons
Occupancy
DESIGNER
PHONE
Valuation
Sprinkler.
0Yits ❑No 0 Ree'6.
Bu1161np Pru In Sp. FL
5' ADORES
ANQE OF USE FROM 6
6.
TO
ZIP
ENE. O ALT. 0 AWN. 0 RPL. 0 MVL OT
7. OF m.['
RH ❑BLD. 0 PLME.- ry w[CNr-OM.N'— O-POOL'-
9.
VALUATION
Source
OAS
ELECTRIC
CERTIFI
I EXE
I hereby certify that I have read and examined this application and have the "NOTILE pnV ons Included
reverseon side, and know the same to be true and correct All provision of laws and o dI . I •. .ruing
type of e work will be complied with whether specified herein or not. The ranting of a p rmit res not mo
n give authority to violate Or cancel the provisions of any other state or at law regula ing 0 struction or the
performance of construction.
DATE -A• 4 /hen
SPECIAL APPROVALS
DEPT. REQ'D.
SIGNATURE
Er
P Routine
F0. Manna
Clearance
SPECIAL C09 TIONS:
TOTAL S
DATE
\� WNEN MACHINE VAII'."
i.1
1
04• •700
+7.00 0
.7.008
*000 8
81.59
02-01-80
6479.
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W FINAL INSPECTION: 3 -
SET BACKS
DATE REMARKS:
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