1980, 07-29 Permit: 80-7492 Inspect� a
INSPECTION RECORD
OWNER
LOCATION
CONTRACTOR
NSEW
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE REMARKS:
t);,f,
„s2. u11®: r AL
r1-
45
rr8 `I
� d
L I/ 9ER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99380 / 1509, 456.3675
JOB •DDRESS
LUI
BLOCK
APPLICANT: COMPLETE NUMBERED SPACES
/ 7i2D gAG
SUB IVI ON
PRI SS HARD TO MAKE 3 COPIES
LEGAL DESCRIPTION - SEE ATTACHED
OwNER
a
ADDRESS
PARCEL NUMBER/S
ZIP
Actual Set Backs in Foot
North
Isouth East !West
j471//
ige57,-/
TO
c.
PHONE
7;714/523
'9 9,g/5i
PFLEINE
Size of Parcel
Type Const.
Ocoupancl, Sprinkler.
Oyes Ohio 0 Pee,.
Valuation Bonding Area in Sn Ft
Mmn Floor
Upper Floors Om,. Area
Area of Docks
Pinioned Basement
Storage
p.n. Basement
TVP. Cilleged 0 ALT. 0 ADW. 0 RPL. 0 MVE.
7. OF
WORK 0 BLO. )1K(Loi.. 0 MEAN. 0 M.R. 0 POOL
DESCRIBE WORK
0 OTHER
No. Mori. (I No Rooms ItIo. of Dwellings
Rocrd INOt Rep,
CERTIFICATE
of EXEMPTION
-VALUATION
9.
SOURCE
UTIP_IFTIES
OA&I 71 re.s.
ELECTRIC1 WATER
Enum. Dist.
Location (Areal
SEWER
ownership
Krone 0 Private 0
USE CODE
I hereby er1 rlht I have read ao(1eArrrrlfl.r r tt, .1,1( rrar 1 Ertl,
on reverse role and know the sari, to (e. true 11,1 arr ir rrl rrirrr rar rrs 111,
type «I nerk Pal be cornphed .1(1 Alo.11,,
In (pre autllorlD varlate nr TT ran 1 If I' r I r.
performance of construction SEE RFVERSE SIDE FOR REOUDIFE, INSPECTION
DATE op Anal IC a r
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Ca Engineer
•
FEES COLLECTED
S gi
Building
Plumbing
Mech.
Nen Check
SEPA
Molailo Home
Other (Specily1
TOTAL $ aceea
(
1PERMIT NUMBER(
.2-a 1 it 4
.3800
.3(300 to-
ATB008
•000
(1.T
C,/-22-80
0079