1981, 02-18 Permit: 81A-1622 InspectY
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W
SET BACKS
FINAL INSPECTION:
DATE REMARKS:
r"
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 011 JEFFERSON / SPOKANE. WASHINGTON 00050 / IOW) 40.0815
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
Al DO
ARERS
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COMRACTOR
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ADDRESS
E.yLLLlPilf Jcsa4.19- .0
D4IONER
ADDRESS
ONE
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ZIP
PHONE
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PHONE
ZIP
P1
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NOMRE RA
911k - A622 -
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6001.
sue el POIOOI
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TYPE D ALT. D AWN. 0 RPL
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WORN
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D M01
. D OTHER
D POOL
In Flea! I YEAR Pew.
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Arg of Desk. 101010,04 0•..nent
•1900
•1900 t
• 19.0021
•000
16212
02-18-9.
Unlln. 0•NmR11
N•.0.1n. No. SWAN No. MOONS 180. of Owelll..e
CERTIPICATE
Roo.. RRC e. He15.00.
of EXEMPTION
(�pper� t(1 [num. ON, Lau1Nn 1A:Ml
B.
OAT milpCL Fda. µ*ACF • I C1`n.1r`T WATER
i! SEWER 000 w[ 0001
A 10 OTILITItl �'a-/f I �oIe 40000.1.0
1 hereby certify that 1 hoe read and a0.0.0.0 This application en\Ove read the "NOTICE" provisions Included
on reverse lido, and know the semi to be true and correct. All proepions pt laws and ordinances governing this
type or work WIMI 0e compiled with whether specified herein or not. The gaoling of a 1'rrmrt doe* not pnwme
s0 She Wthodty to NOW or cancel the provisions of any Other stele ur local law regulating construction or the
performance of construction. SEE REVERSE S10E FOR RECO! ED INSPECTIONS
DATE OF APPLICATION a 1V - S I SIGNATURE Or PP
SPECIAL APPROVALS
NAME DATE
Em. WMIIh
SPECIAL CONDITION'.
•
PI10 COLLECTED
SENA E.
SONI )
Plunging
Mech.
Ran Owls
SIPA
Mobil. Nom.
Other (Specify/
TOTAL •1ZYLi
WHEN MACHINE VALIDATED IN TNI[ PACE.