1981, 05-28 Permit: 81A-5129 Inspect01-71n4 'c4
CONTRACTOR
INSPECTION RECORD
LOCATION
TYPE OF WORK
NSE W FINAL INSPECTION:
SET BACKS
DATE
5 Zg=B-1
c
REMARKS:
e
POUR" Yet" �. � APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
tt
000TH611 JEFFEAEON / SPOIMNO. WAQNINOTON 09]60 / 1600116ROslo
APPLICANT. COMPLETE NUMBERED SPACES
e ADDRESS� day �J n /
LaR����y
- PRESS (HARD TO MAKE 3 COPIES
LEGAL DESCRIPTION - SEE ATTACHED
L NU▪ E R/S
TON
.a
6TOR
694/4/.369
�9Eao,
Aa1041 S" 0.41,6 In P..1
IeaR,R
91100E
arae
•.1 ewu
Lfell
�M a1.NnR.
t DESIGNER
• ,7a 7
4ryaa v
lbMA„..d
❑v.. One ❑ ww•a
9100
•101/00 I9u None Ww In sp. Ft.
ADGREaE
CHANGE OP WA FROM IT0
I7. OP
WORK
ZIP
io �OPPNFloFloorsFe
Ar.. r
Oar.. AIM
iMlrn* O.Nnl.n
•rfEW 0 ALT.- 0 AWN. ❑RPL ❑MVO.
G OLD. 0 11.MtaecnM.N.. 0 .N. 0 pooPURL �of NER
No. Erten
No lrbW
No Roo mt 1No. et OW.0I
CERTIFICATE
of EXEMPTION
Read.
K'0. IVa, RP'd.
DeileAl
VALUATI
9.
az
poLn ON I ELECTRIC I WATER
:3,1,111600,5
nur
x111.51.1. 1L0ml.1i 00
SEWER
NIM
Pik OMPan 0
USE CODE
I hMby cattily that I hove lead end examined Ohs application and have toed in. tall ICE'. nrtlN.u)11, 110111111.11
V11 TOV0/110 side. and know the tomo to be true and Cmlac1. All 10000010 01 laws 41111 0011011M0, 11100011100 Int.
Mie of work will be complied with whether waolfied 10111101 cat nul. Th. 9rannnu m11 dare Onl pl.Nwno
to Elve authority w viol.n or cancel Ilia provisions of any other stare o. lain 00 01,10111111 1:0110 1chwp 01 nW
performance of construction. SEE REVERSE ItDE FOR REOUIRED INSPEC''()NS
DATE OF APPLICATION 5-4 / SIGNATURE OF APPLI
SPECIAL APPROVALS
NAME DATE
Env.
rang
.,alero.E
44444, 09NDI�T1�91Nter-e
FEES COLLECTS°
sew i
Building
Plwnbane
P. 140"
Pion Chock
E0PA
Moons hen.
OINI /3070 Nl
I eLl
TOTAL SL
PERMIT NUmOEN
Ou•
• I r< n
• In
•14.0
•1:1Q
n5 -2'r -S1
61179
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1