1980, 12-23 Permit: M80B-5194 Inspectc
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
N S E W FINAL INSPECTION:
SET BACKS
DATE REMARKS:
NIE APPLICATION/PERMIT
Lq SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH atl JEFFERSON/ SPOKANE. WASHINGTON 66160 / 16051 166.0673
APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
JDE ADDRESS LEGAL DESCRIPTION
— SEE ATTACHED
1 e 5r
91
RCEL NUMI ER/S
2
PHONE
OWNER
3 L '
ADDRESS ZIP u.l SM -.In, FM
ONF Stn of Parcel tow
CNmnunenr
�' ADDRa'85 ZIP TY«Covet, ccup.ncY
SPrinklw«
11-1 ❑No Mae'..
DESIGNER PH..E lu.tlon SullpI.,
Ar« In Sp. Ft.
6' ADDR[4 ZIP .In Floor pp.r Floo
.,... An. Stpr.«
o
CMANeI OP Ua[ FROM TO Arw or Flinered M«m.nl
Unfln. ase—I
I
N
No. [.t0a o. Stories
n FW ❑ALT. 0 ADN. C3 RPL. ❑ MVE. �
N o. Room. ..1 DMeI ver
OTHER
T o &(MECH. ❑ M.H. 0 Po I
❑ Co.aO PIAtE. of CERTIFICAT
wo AK
of EXEMPTION
OESCRIae WORK loom. old. anon (Arwl
FEES COLLECTED
&
Vq LUATI Oq5 ELECTRIC WATER SEWER --,..p USE CODE
p, uTIL.TIES Pppne 0RI..t.0
SI qN f
I certify that I have reed andobe examined this application and have read the "NOTICE" provisions included
raver side, know the same to nue and correct. All provisions laws and of dimness governing this
BuiMllq
et ra
eeofr work will be compiled with whether spncilied herein or not. The Granting of a permit tloes not prewme
type11
to give authority, to violate or Cancel the provisions of any other state or local lase regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT NS
FkWQirq
FT^'{'�`/
a'� P
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DA I L OF APPLICATION O V SIGNATURE OF APPLICAN v' —
M«a. 'f 2•�
®ECTAL APPROVALS
IIECIAL CONDITIONS:
NAME DATE
Ran Check
SEPA
KIWI. I omen
--In
rr
Other ISPeeifv)
TOTAL i 7•�
w w
n«
Plant �nnn.,
04• +900 h1'j�
•700 �
•7.006
A -Goo a
519.32
12-23-80
2 64791