1980, 04-18 Permit: 80-3631 InspectINSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSEW
SET BACKS
FINAL INSPECTION: 11 ' d1-' i
DATE REMARKS:
V /t J
661/<-
NORTH 811 JESPER6GN r 3005ANE, WASHINGTON 80200 1 MIN 404-3670
APPLICANT. COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
A.pC.RESS
} .$'� t, LAT ver
l of f•1/
,{ 2.
7 4, 711.14.4.44.
vry,.t,
fthlgRoe
lQX/LQ(/ a�.
tat
LEGAL DESCRIPTION — SEE ATTACHED
NONE
926'/768
.AR EL NUMBERS Q x/ /%T', ..JL, 7
,Ler 7 47.>d0
HYRON 2$7A7'$ 'ort
ZIP
94zab1.011
Actual SN Backs In Fe
PHONE
924,-6 -s-
ZIP
9E74..//
arW
panes I
■ Sprinkler.
OESIpNER
5' ADORE10
PHONE
0IIANBE OP USE IRO
a
0 New
7. woes(
❑ BLD,
ORR
0 ALT. 0 AO'N. 0
❑ PLMe. 0 MECH. 0
❑
OTH
OL aA
I10 �O BUIMIne Area In 3a00,0 . Ft.
t
8. lo91UPar Mono 01ra1 Area I Stary0
/faa`f D«W10INsn3d 6.Nmant Unfln. B1MrIIBn�,.
No, Baths 1 No. Storlea No Roolna No. of BWNlln E.11 >,.
CERTIFICATE RN/a, Rea a. �1VIIEiA'�I.
e/ EXEMPTION oS
1e
OAS
...aAA.A. r
er1..
ELECTRIC WATER 1 SEWER
nuns, OM. !LRA MN.
0/1101013 M1: 000E
Molle gPTNtle
000Rfy that 1 have reed and examined thi6 application end have read the "NOTICE" provisiklpluded
on reverse side, and know the same to be true and correct. All provisions 01 laws end ordinances governing this
type of work will be complied with whether specified herein or not. The granting 0f • permit does not presume
to give authority to violate or cancel the provish>m 01 any other State of local la W regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF AP9LwATION SIGNATURE OF APPL
SPECIAL APPROVALS SPECIAL CONDITIONS: -•�nc�.L.OK®
NAME DATE
cs,L6usC0.11.44- — SBL
PERMIT IS NONTRANSFERABLE
PEEEDDLL
N o*
E OSIN
Plumbing
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.