1980, 12-03 Permit: 80B-4048 InspectINSPECTION RECORD
ADDRI(r7'
DATE
/2-7- 8c.
'
REMARKS
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APPLICATION/PERMIT
SPOKANE COUNTY-BURBUR-DINGCODESDEPARTMENT
NORTH OH JEFFERSON /
APPLICANT: COMPLETE NUMBERED SPACES - PRESS IIARD TO MAKE 3 COPIES
LEGAL DESCRIPTION - SEE ATTACHED
fra "zsn s
t./ 7/5 /7 rn
- t —gwtK SUBDIVISION
z /o I / I o se .Sr,/ rgrDA/ef 5
OWNER
3. /1.4775 Tie CON ST<r+c T.a•v
ADDRESS
5. ZZ/G. R0Ur/re.x
CONTRACTOR
4. ADsDREssTESS
S4inG
A.OA/r/nom
PHONE
4ea-ve7/
ZIP
9`yo37
PHONE
ZIP
PARCEL NUMBER/5
ZGS4/-26/6
Actual Set n /Se'
15out 35' East a?' 'west /5'
Zona CHaBlcetlon
Sim or Parcel
/05 X zz9 !-5'Ng'E FA/n/,/
SsOnklereal
011.s 0Ne 0 Reed.
Tr e ry. 1
OccuPa ser
DESIGNER
6. ADDRESS
CHANGE OF USE FROM ITO
PHONE
ZIP
Id NEW 0 ALT. 0 AD•N. 0 RPL 0 SIVE. 0 OTHER
WORN IL BL f . 0 PLMB. 0 MECH. 0 M.M. 0 POOL
DESCRIBE WORN
8.
VALUATION' A 6:10 72
RAS ■ELECTRIC I WATER SEWER
8. .5. 390NIUTILITIESI I �`PY/C �illlls
1 hu eby uu I Iv that I have end and examinedieti the N ledon
ev x side, x110 know the seam IG t I Leek
` HGI t
type°1 well, will be complied with whether ni rennin
toglee authority to violatepr cansel weenie., dIy II Ixw 1
u I/O
performance nl construe/loft. SEE REVERSESIDE FOR REQUIRED INSPECTIONS
OW 1,4 APPLICA rIIIN _.- 7 ,52') 1.I A/111011 rUl I ICANI _
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Building Area In Sy. Fl.
99B
Va� 3 39U
er Flous Garage PmI Storage
/27, ein e — 72B
Area et Decks I FI6��/Basement I B�Basemenl
o. Stories No. or Dwellings
Nazthe I N Ng.� em.R
Reo.d: I re;;
CERTIFICATE
of EXEMPTION
EMIT. Ola. (Location IAful
ownersine use CODE
Public
0 arIvate
FEES COLLECTED
Single $ ��
Sending �;q5•/°n
Plumbing
Mech.
Poen Check
SEPA
Mobile Hems
Oter1SPeclh)
TOTAL- S psi
t✓csu57 360< 7,7s?.
yL2/$¢
02• •29500
929500
.29500E
A •000 8
38003
11-17-B0
o 6479.