1980, 10-17 Permit: 80B-2004 Inspect T __
INSP'ECTION RECORD
LOCATION
tibtitmAcTon TYPE OF WORK
• N R E W FINAL INSPECTION:
Si?BACKS
. DATE i KEW K• - /(1?2
' 0-1‘ ' 44 -)`" 1
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PLAN'! MIKR _ _ __ APPLICATION/PEF. I�' `1 {J P[RMIr. T...'
SPOKANE COUNTY—BUILDING CODES DEPARTMENT 'I %O —z0�
NORTH ID.JEFFERSON ..DEAF WusHINDTOry 99360/IISTI•40-3476
APPLICANT: COMPLETE NUIVIBEREU SPACES PRESS HARD TE'MAKE 3 COPIES
aoe ADDRESS __gg LEGAL DESCRIPTION—SEE ATTACHED 0!I+ +70 I
'' D(�6�eg 9� 5 Ponce,NDMeER,9 :70:,
E �
yy to-Is—e6
3, .pl -71 i..0 / 92$ 7e�/ ACt. P«t
ADDRESS �/ ���/71�� ZIP a sal Backs n . 6679.
f`•/etb08 /44c/.,a,,,,./ /Jo.,14Aai, �o o37 sl,e o,Pa,. isooIn Eton.CI.NIa Ilun.I
OpI TOR
A ADW94 ESS rvP ce..r. ou.P.w sok er.A
.41 .; ❑v.> ❑ . ❑N.a'e
DESIGNER PHONE va uaI on Bu Id n9 Area n SV.Ft.
6' ADORES ZIP Mem F oor UPvrt Flaon •rags Am Rvrave
CHANGE op DEE PROM ITO Ar«vl O.ck> P nHn«ea+.meat Unl e.e+um+m
No.0ath> No.Morin No.Rooms No.of Owelll«>
Tyre ❑NEW ❑ALT. 0 AWN. 0 EPA. ❑WE.
• 7. WoRR 0 DLO. ❑PLIAS. {t1 MECH. 0 M.H. CJ POOL 0 OTHER CERTI NCATE Flar'd. RaeT0 Plet Rena
PI E%EMPTION
.��r� Enum.DI.I, LPullon IAr«I FEES COLLECTED
A
LUA ION SOUR CE A! ELECTRIC WATER SEWER pwnerlM1lP USE CODE
O. UTILOITIE9 Public❑Prlvele❑ Slnole S k)11"'
1 hereby cel Ohl that I have Idad and ex/emoted Rnd tl a n1'III t,i 11 tn,w d avo rud IP 'NII f I IOVISlons cluded
Sltla,
toeo of work will kncomplied
withwhether 1 11 /�I V t 1 rionvoettnernen uthreo
to E authority tO vIols[[Ort4 S o OI any I 1' w y w Islrup[on o the
.grformEnre of nwnstruCtlon.SEE REVERSE SIDE FOR HEOUIflED INSPECTIONS
NBuwlindblnmp
s � , ;,
o
`DATE OP APPLICATION/Q./ LVA _SI0NATD ill AI".ICANTylr_C� CJ/3 -e MCh. 1- I
SPECIAL APPROVALS SPECIAL CONDITIONS: _ Plan CAack
NAME DATE
Env.N«Itn
SEPA
Df renin
Mobile Home
Ohall
+ e
!colo«. Other IEP«ifvl
MIN. t7
TOTAL S 9�
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