1981, 07-07 Permit: 81A-6697 Inspect4
C
ADDRESS
INSPECTION RECORD
DA= REMARKS
9-fsc' n�h� ( tZ�
HUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE. WASHINGTON 99260 / 15091 956 3679
APPLICANT: COMPLETE NUMBERED SPACCS — PRLSS HARD TO MAKE 3 COPIES
JOB ADDRESS
Lor GSA
• IO '!
LO 11 -At
LEGAL DESCRIPTION — SEE ATTACHED
Wmu S1..6V MMP40R 1T Aco.
a .
OWNER
I . W NTv-"vs
ADDRESS
W..t54zs L.O4a6.fev_u 9..1
PHONE
4z , -o, i
PARCEL NUMBER/5
01542-Z31b
z6Z1.44.
Actual s.t Ba«a In Fmt
North 51' [sown IE.st 5T kw.. Z6'
CONTRACTOR
SAM6
4.
ADDRESS
SARae
PHONE
ZIP
Size of‘Parcel
X 1 p0
Typo Con.
Ton. CnaaRlmtlon
ACG S.AI'SuC,a(AF3
sprinkler"
oR 3y ❑Y.. ono ❑ R"•d.
DESIGNER
6' ADDRESS
PHONE
Y. 5
TIP
B uilding Arm In Sn. Fl.
7 z
zO
Main Floor 1 Unpar Floora
I Garage7
stores.
CHANGE OPUSE FROM
TYPE 04.w
7, OP mJ
WORK LO.
DESCRIBE WORK
❑ AI -T.
0 PLfis.
ITo
❑ AO'N. ❑ RPL
❑ MECH. 0 M.N.
D.ek.
Flolshan Basement
Umin.e.a.m.nt
❑ MVE. O OTHER
❑ POOL
NG Baths I No. Stone I No. Rooms 169. of 0.11lest
1 1/I
CERTIFICATE
of EXEMPTION
O ". I Reca. Platy"
a Tamar T :6 4 C'I A2Pfa1E
�L VALUATIOOL Ttfi OAS
IT.'��52G IE9
I herby cattily that I have read and examined th lti aIlI,I!c:ltnnl nnU
side,ou reverse and knOW the tO b. true 1 c,e 011
type 07 work will be complied with whethipsI (ivil (I
asitilOrity 10 GOMMcancel OV i •n ..•
f au struct on SEE REVERSE SIDE FOR RI I)IIII LU INSI'CI /IONS
r /
Enum. DM.
LomtIon (Areal
ELECTRIC 1 WATER
SEWER
s0PTN'
Ownership
I/
a p D ,1..t
USE CODE
O 01/ 01 APDL CAT ON 6/ri 511 NAI II 01
SPECIAL APPROVALS
NAME DATE
SPECIAL CONDITIONS:
/...iii
PEES COLLECTED
B' gi E �n
Building'Sn
Plumbing
Mech.
Plea Check
EEPA
Mobil. Home
Other *pacify)
TOTAL 0-,cJ,TA
66963
06-07-8.1
3 6479
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