1980, 09-04 Permit: 80-9521 InspectOWNER
INSPECTION RECORD
LOCATION
CONTRACTOR
N S E
TYPE OF WORK
W FINAL INSPECTION:
SET BACKS
DATE REMARKS:
q"--14FJ Lel
ONOINI
N NUMfi[R
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 911 JEFFERSON / SPOKANE. WASHINGTON 99260 / 16081 4663676
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
J0 ADDRESS
LOT/1 A 16isifslo'F�-Ei�.,
2
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
PARCELNUM0ER/S
0: TRACI oR•
Yll.�/VLlf
ZIP
H9 .oG
Actual Sot illeces in 6.1Norte !Sown :v04
w 1 Lott
AOffESS
DESIGFaER
5. ADORES&
ZIP
TYPO Const.
PHONE
kl
0:26.na Sprin ww
ONo 0R.MBUIgrnOArea In 5a. Ft.
US. of Parcel Zone Classification
Valuation
ZIP
Main Floor I UMW 0100“ Garage Arse
Storage
CHANGE OF USE FROM
A.
TO
Area of Decks
FInIMan easement
UM in. Basornont
TYPE
7. OF
WORK
❑ NEW 0 ALT. 0 AO'N. O RPL 0 MVE.
O SLO. o FLM.. //kMEC0. ❑ M.H. 0 POOL
0 OTHER
VA AT SOURCE .'V) I [L[CTRIC kWRT[R S!W!R
9. uTILITIEa
No. oat. I No. stale. I NO. Room,of Dwelling.
J aw'a. Ra<'e. r., Raced.
CERTIFICATE
of EXEMPTION
Enum. OM.
Location (Araal
Own.NnlP
P1.10110 D6712.1• 0
USE 0000
I hereby Certify that 1 have read and examined Ihu appllcabun and nave ,, a,l the "NOT II'E" !envisions Included
on reverse side, end know the same to be true and correct. All p102110n. of laws and u.... , governing this
type of work will be complied with whether specified herein or rMonnem,. I he wanting of a pes nm
ut presue
10 give authority' to violate or cancel the provisions of dnV Othel stubs ,,, Dual law rulaileli,'i ..rrpy truchon of the
perf0rmarKM Of comtruction. SEE REVERSE SIDE FOR REQUIRED INSPE ONS
a l�
DATE OF APPLICATION J �� - siUNAIURE in. Ai 1'Ln;ANI
SPECIAL APPROVALS
NAME DATE
env. HNI
19991991
Ira MN.a.R
C Engin..,
SPECIAL CONDITIONS:
jvf.vl .A.-(:GC<t-y0 4.0.-544f. &ad '+-
FEES COLLECTED
S 91 $
Building
Plumbing
Plan Check
SEPA
Mobile Nom.
Other ISPecifyl
TOTAL $ J
M
NUMBERPERMIT
04.
05202
2700
•700
09-02-80
6479.
•