1981, 09-30 Permit: M81A-9179 Inspectl
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W
FINAL INSPECTION:
SET BACKS
DATE REMARKS:
1
.u'w i RON/ ranee' I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT6NORTH
811 JEFFERSON / SPOKANE, WASHINGTON 99260 / 1 091 .62676
10111ESS
APPLICANT: COMPLETE NUMBERED SPACES --PRESS HARD TO MAKE,'t'
12016 S. 12th
I
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOLK AIWA ON
2.
PARCEL NUMBER/S
OWNER
l M.S. Jacobson
PHONE
926-8052
ADDRESS
12016 S. 12th Spokane. WA
---CONTRACTOR
ZIP
99206
Actual Sel Sacks In Feel
North ISoutn E.R IWM
Valley Fireplaoe. Ina.
PHONE
o
Site of Parcel m CMRHlutlon
4. ADDRESS
R. 16610 Sprague Ave. Veradale, TeP990S7
Occupenq r n
Tree cwK s I
Ov.. Oreo k 0 awes.
DESIGNER
g, Contraotor118p CLBlty
PHONE
BelmtionBuilding Area In Sy. Ft.
ADDRESS No. VA LI. 4,"626 0111ZIv
M em F loor Upper FMPGarage Arm SIH...
CHANGE OF USE FROM ITO
6.
Arm or Decks FInIKIw Balemenl Unlln. Bemment
~�L 0
0 NEC a ALT. 0 POW. 0 RPRam
® OTHER
No. select No. Slone. o. Room. No. of Dwellings
O OLD. 0 AI. 0 MECH. ❑ M.H. ❑ mom.
. WORK R
CERTIFICATE Rw e. aee a. I lot Rw'e.
of EXEMPTION
°"""eP.wopK Install Blase Prinoess Woodstovo with
9 i�ay1otoi nhlc y end firs wglls.
!num. DIU. Lomb. IArml
FEES COLLECTED
V ATI N
5.
SOURCE GN ELECTRIC WATER I f[wEp
UTILITIES 1 J
fnlp USE CODE
106)00Prival. 0
SngI $
I hereby certify that I have read and ex aimed this application and have ball th, l h fh lh,. .,..
reverseon side, and know the same n be true and corn., MI previsions of '!.,.. I,IIn,aO. , ,. I,
Building
r ,
type of work will be complied with whether specified haruil• ., not. The smith.; „ l I pm mit d,.u. 1, ,.,.,
to give authority to violate or cancel the provisions Of al.v °IBM SM.. local Iaw red II.II„n1 c0,.l,.Mu mrn nn•
performance of construction. SEE REVERSE SIDE FOR REOUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION $lItNn It IRE 101,API.I.II'/,N/04t
Mech. 4n ECM
._-r—Jr.,/—.
SPECIAL APPROVALS
NAME DATE
ECIAL CONDITIONS:
Plan Cheek
Env. Ha 1h
Ready now for ins eotion.
SEPA
Fannie.
Al
Pasties li
/ / ` /
Moble None
ao. EmmaR
.e,//
Other ISpeeily)
uta
TOTAL S itl'w
a[R
ri $NVM`
119-01114 /
04♦
:17.00 '0
r17.00ti
6 +Q00. 3
917.8 /a'
Iii.