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1981, 03-24 Permit: 80B-3560 Inspect INSPECTION Rix= ADOESS DATE REMARKS kC"'y Pa3/6 /len' 11 er:N--)//2-(:/t • • f //~D `/ DA,ADDRESS /0..,/g0 SPbKA YAPPWAt{QEDL�`4R ORTM4 KANE,WASHINGTON 98160/IbPOBACR466-3676 S6)6 APPLICANT: COMPLETE NUMBER F! SPACES PRESS Ifr,R)TO MAKE 3 COPIES NT PERMIT NUMBER ` (V° 1�1Ir L 1 +5600 r ' t. e 611/0 /O.zQvC(idL LEGAL DESCRIPTION—SEE ATTACHED +5600 15LOT OCR SUBDIVISION PARCEL NUMBER/51/S37-/../.4-#4i Z OWNER PRONE �f t �y Wr•'.,',./.,w r_9 Arc L P Lary E,:iy'� +56000 3. A•�/M)HIa.f.," ��OgL/,(i/J,L.y(� �,�-.70,S.Z /"d rJ I74K..5- s/nR to o w wv,TCA •000 0 RE'S / ( �pp Ac u,1 Set Vick.In Feet r I fl E,6 O /O . RCl,ae-T6At4 c o 9206 min z.s 15outh 76 I as//G. IWO PZP I,: 2r on oneCla,anutlon I L-C,3-80 ♦. 2t/MD BC/2/x,11LG4rz/-' 9:1(,-652.3 skOx/Z7 Qf" a•�, nerd ��yaize of Pawl. z o` •:u d, >i 6479. n 1402/P. '`f- 4Fx sif u_. 9Q2/1. 'V-t-A �`Mc Dv.. ❑N. U Corp. ., DESIGNER 6. pHDNES/�It`�- .IIUI`AO. �P sl_p. ADDRESS DP G FI tler CHANGE OF USE FROM �n' r Pp.=-oor .,...•/- �� S. TO e f DeecMk''��N+�✓:IR�a�? I Basement Baths No. NO T. WORIp SLG. ❑FLMa. ❑mE N. ❑m H ❑Poo( U OTHER NO.CERTIFICATE/ � n Of Ow a b F� E of EXEMPTION epom yv�Re D45 R E RN 'urn' nu f on(wrul 9. + /y am L''." FEES COLLECTED iECTRIC WATER SEWER Owners: USE COOS 9 VgLUAT1ora UTILITIES Pool,0Private X_ Single j I hereby certify that I have 1arld:n I I rirl 1 Iu 'd the"NI I I 1.,.,...srns eluded D reverseon s dc,and k aw 1 n, .li I 1 cor AI sCl I' Bove Ing the r - b. rypeofwork will be COMElied with whether I d eI I I he gra tt nq II ,hoes.,or presume Buildup V to give authority to violate or cancel the prnvl..ons of.II ow... I .I local law rrnpil:.Inm construction or the performance of canstmction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing DOTE or APPLICATION ,',I`r L APPROVALS '3 SPECIAL CONDITIONS: NAME (Cl:PnI'AN _ t,fuap� EWE . SPECIAL DATE ' /f.(.C1M.QQ�(�/( fl 0/•a/0--8/ Pim Check PF a _ /Y,5._ ?-6. az-e.c.C....fL...1.,V.. 1/ BEM •,,C.4...2Mobile Name • Enpina.r • Other ISeeclIc I them J,.m _r TOTAL 9 VI. �" r WN EN MACHINE VALOr TEO IN THIS SPACE