1980, 07-10 Permit: 80-769 Inspect INSPECTION RECORD
•
OWNER LOCATION
CONTRACTOR TYPE OF WORK
N S E W FINAL INSPECTION:
SET BACKS
DATE REMARKS:
4
7
I rtrar,4lIs view.'I E—sUls_oeM ...._ J ( J .
NORTH IIIJO N M
PPPPPP / OEAUE,WASHINGTON wa.a,teal. ..aas. DArc 11'�J4f��YRy JI/JJJ
7hPraLICANT, COMPLETE NUMBERED SPACES-PRESS HARD TO MAKE 4 COPIES
BnDDREss 30---7 (
00
LEGAL DESCRIPTION-SEE ATTACHED 03~�'��
1. O T OLR tlDL10xLD -35thIVIgIDN PARCEL nVMlER(a a 300 k
LU
2. •3009
OWNER pH
oNE
3. John Jordor_ 928-2798 E 5 000 9
ADDRESS 210 P CONTRACTOR PHONE 99206 Norm I omni 7 h 4
O TRACTOR PHONE 41..el P..c.l W.at - 01-31"80
�,
Soft Water$ervie.Cg. 455-8050 e•aN.ml..uP1, y IS d 7 9
DRESS ZIP - rvw cnnat. o«a..ppr
DslDorod
E. 2.5 Th:t d Ave. 99202 Oral ONO k 0 Rail.
R PHONE VOatlon lWlelee Ara In Sq.Pt.
5' ADDRESS ZIP DWL Ara !Moment Ana a.....Ara Slon.a ..� -
CHANGE OF USE FROM TO Rancher
6. scene E Iry scene La•I
TYPE ❑NEW ❑ALT. 0 Awn. 0 EFL, 0 SAVE.
No.Baths No.'Wore. rvo.Rooter R.c Roam
7' OF O OTHER
RH O BLD, [MPLa., ❑meo.o—Q-MH" ❑PoOL CERTIFICATE - Ry'O. Roc e. lbl AM'S.
O[SC0.1!!WORN of EXEMPTION
8, Water Softener FEES COLLECTED _ _
VALUATION OCR ELECTRIC WATER SEWER
g•
MI:. <
Sinpl. a
1 hereby certify that I have read and examined this eeplicadon end have read the"NOTICE'"provision.Included
on reverse
side,and know the same to be true and correct.All provisions of laws and ordinances governing this Sulking --
type of work will be complied with whether specified herein or not.The granting of a permit does not presume :;,;ye;,•,
to give authority to violate or Cancel the provisions Of my other-Hee or location/regulating constructfeR or-the --- - *',-
performance of/construction. nurblp '" _
U.,IF 1/♦8/W - ---- SIGNATURE $Oit Water Service CD:`-.. .gin. i ";-i
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT, REO'D. REC O. Plan Check
Env.Heath ..
.e
Nanning SEPA
Flr.Mar.n.11 .. Mode.Nom
Co.MHO.. .- Other ISpecifyl—
UNION. AQ- -R
•
TOTAL $ Ii
ZoneClearance
:'447;0 MT�1 I e dy.P E.
/�� i'Al I 1 WHEN MACHINE VALIDATE IN THIS SPACE.