1981, 03-28 Permit: M80B-4201 Inspect\ INSPECTION RECORD '
OWNER LOCATION
CONTRACTOR TYPE OF WORK
N S E W FINAL INSPECTION:
SET BACKS
DATE REMARKS:
,.r
----! SPOKANE COUNTY —BUILDING CODES DEPARTMENT M P��'MB q -J -O flj„�n p".lV
NORTH Bit JEFFERSON /SPOKANE, wASNINOTON 99NO / 16091 4603676
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JDB A sE sr- LEGAL DESCRIPTION -SEE ATTACHED
E ot/ -,u FAec [iia 9 o Oqe .7.p
PARCEL NUMeERrs
2 C/.er sT as ' 7u 0 r la
owNEfl PNo
3V/ -7-00.1
-
-
ADORE44 ZIP fuel Sar BacNa In Feel A .00o
/soo d' f „Ti Sr //exwt.Rlr 99037
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CONTRACTOR PHONE • or Pard M shah..".. 4200L,
e' A O ESS 21P TYWConal. UuOeney I Sprinkurq 1-1`25`86
Ov.a CNe ❑R.9•e. n 6479.
6.
TYM ANEW 0 ALT. 0 ID -N. 0 RPL. 0N"'.
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0 .LO. 0 PLM.. W M[CN. 0 M.N. 0 POOL 0 DTNIfl CERTIFICATE Rp 9. Pea e. r N d.
WORN
91 EXEMPTION
DESCRIBE WOgR loom. Dial. Leaetlonl rut
a .-I-11"Ariod-VAS d tUPoO Sro✓r-
FEES COLLECTED
LU TON SOURCE GAS ELECTRIC WATER ZWE T Nmp U0[ COOL
OF Puallc ❑PrNela ❑
g. TIES
67.074 {
1 hereby certify thatlI hays read end.ennumul this applies[;.. and hove read the "NOTICE" pl ovislons Included
on reverse side, and know the same to be true and correct. All pl—hous of laws and ndillances governing this
type of work will be complied with whether specified here not. The granting of a nahrut does not presume
S91Nnq
to give authority to violate or cancel the provisions of any other state or local law regulating—nitruction or the
performance of construction, SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbkq
�V � � �'c""�
DATE OF APPLICATION // __ _ _
SIGNATURE OF APPLICANT
�h•
WECIAL APPROVALS
WECIAL CONDITIONS:
NAME DATE
Plan Check
Mob.. Rom.
P
Done, lSpxifYl
a
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TOTAL 6�
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