1980, 07-03 Permit: 80-6638 InspectOWNER
CONTRACTOR
N S E
SET BACKS
INSPECTION RECORD
LOCATION
TYPE OF WORK
W FINAL INSPECTION: �-
DATE
REMARKS:
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
, NonTH 911 J...ERaoN r 11O0AN1, WASHINGTON .0260 / 160014013020
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
A2. AOOREM
Fica(e.5-5.
::RT
3
ADDRESS
Jen.
fea(
ADDaa.
t Ir2Y tlr.L
9z* i<d[4
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUM.ERR
ZIP
Actual 5.1 S.ckI In i1.
11000 IE..I IMAM
PHa.a
416-f'YL10
SW el Pekin
Taw C.wn0nlon
;zIP
42 /
S .
Da300[R
PHONE
Ty.cenn.1 Gecuwnp P.m.u1•a
O.. ON. 0 RMIe
WW1. n SWIM. AIM In So IN
4DCA[a
00100 U..P
a
TO
la.m Floor LW.. Plows r N..... Alm
ktM of OM I PfnAfi 11.m I
Ty0
..VNEW 0 ALT. 0 AOM. 0 RPI.. 0 MVC
7,
no ❑ 11.0. CIN. WM.N. PLAI...tH. 0 0 root.
OT1NR
A MI
0110.1.
O . •r D.NIIeel
ON ATIPIOATN
W EXEMPTION
Amid.
nue worn
a
m. 01.
Laalbn to
ALUATI
a
SOURCE ✓ OAS
Lunacies
SET. R
Chvowsnw
Public 00r/cars 0
1150 CODE
1 hereby certify that I hove nM and ...tined this applicator, and have reed the "NOTICE" provide.. Inoluded
on mars. fide. and know the .amt to De true and Correct Alt provisions of laws and ordinances governing this
type of work will b. complied with whether NMeified herein or nor, The emoting 01 a permit da. not pr.lu16
to give authority to allots or cancel D1. provisions of any other Mat. DA local law regll11104 E9n.trutti.n ere Ma
performance of Construction. SEE REVERSE SIDE FOR REOUIREO INSPECTIONS
illGATE OF APPLICATION SIGNATURE OF APPLICANT
MnAL APPNOVALN
NAME GATE
Enc 01.1111
Dunnino
ill. 01..11.11
[n 0n.In.,
101101.
0.111 E..n
OFICIAL Cp1DIT10NIC
PERI COLLECTEO
5 0 • d3
euumno
Plumoln5
Mach. GP
Pim Clock
SEP4
Mob. Hon.
0111ar IOp.clfy;
9-°'
TOTAL f
TENMIT 01150 y
# (Yi=—`moi= Ali, (J�
0G• •9.00
}400 t
*4008
E
•000
663711 mitialodif
D7-oa
A 6a7a
WHEN MACHINE VALIDATE O IN TH15 SPACE.
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