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1981, 04-01 Permit: 81A-2986 InspectINSPECTION RECORD OWNER LOCATION CONTRACTOR NSE W SET BACKS TYPE OF WORK FINAL INSPECTION: DATE REMARKS: 91.09559 APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH St JEFFERSON / SPOKANE. WASHINGTON 611250 / MOW .M.3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 19 ADDRESS '1. yi ■LOCK pap ie y-�`OletllR j a Dean Collies UweN 41609 <Iv meyval CONTRACTOR * T.ngqned��et to ❑ever e t X20 S.'#'SIBt'i�"1'S.pok�ane DESIGNER 6. ADDRESS LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/5 PHONE 928-3063 ZIP Actual SA Baths In Root nam south PHONE 448-1008 SU. 01 Parcel ) Zone CiaNltlolton LIP 99203 TT. C.A. Oe:ugnq ❑VM ONo 0 Pp'0. PHONE Valuation Iaondlm Arsa In se. Pt. ZIP Main Floor Upper Moors 1 G.r.0 Ar.. pewee OP VK PROM .1 TT95 ftNaW ❑ ALT. ], Of WORN 0 SLG. jlffLal. .:a OSSCROM WORN e ankl JAt I+R+I Soo Da e OAS re.. Ural4ln ITO 0 AO•N, 0 MICH. Arita of DpIR "MANE semen Untln. Sawmpt 0 RPL OM.H.' ❑ MVS. 0 POOL 0 OTHER No. Paths I No. Stories I No. Reams IN°. et Dwellings 1 ryas Rp•d. CERTIFICATE of EXEMPTION ANN. Enem. DPL Location (Area) ELECTRIC WATER SEWER Ownership Pe0111 0711..1. 0 USl 0009 I hereby Certify that 1 have Ned end examined this application and have read the "NOTICE" provisions included on. *este tide, and know the same to be true and c s correct. All pro of laws nod on -finances nances governing this of,work will be complied with whether specified herein or et, The granting of peimii does not presume 'TO give authority to violate Or cancel the provisions 01 any other state or Iahoy const uction or the performance of construction. SEE REVERSE SIDE FOR REOUIRED I DATE OF APPLICATION 3-30-81 AREAL APPROVALS NAME DATE Eno. 160110 , Engineer SIGNATURE 0 SPECIAL CONDITIONS; FEES COLLECTED SIneN S Bodging Numbing —5L-0.0.— Mech. 5L 0OMech. Plan Check SEPA Mobile Hone other (07.cifv) TOTAL E 9 pn NUMMI NUMMI T. P I - - a- 03• •400 •9.OP'. .41011 A •000 ie 29852 04-01-8,1 • 5