1979, 11-09 Permit 79-6820 InspectIPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY BUILDING CODES DEPARTMLE1
NORTH SII JEFFERSON / SPOKANE, WASHINGTON e5260 / ISOol e65-311IS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1' LaT�bC%SaoIORIaIT ^LGC
4. I
o R / p
3. oodk 5-L� . i1'..(.i�fftQf'
J11 c� OO dab," A�
4.
COpTRACTOR
O[ll./}Ai/1
'ADD ESS
Jnl aalnhf-e
NONE
;/,2 e)
ZIP
ONE
ONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
Rana free set !HIM In Feel
Norte IEOAIR
SIM 01 Ansel
Occupant
mu on
SPrinklered
Oyes ❑No 0 Raa'd
DESIGNER
5' ADDRESS
PHON
Valuation (Boilable Arm In So. Ft
ZIP
DVSL Area
engem.m Arad Damp. Arm
CHANGE OF DEE. FROM
6
TO
Split fen
Sont Level
7. TVPE y -,ta D ACT. ❑ AWN,❑ RPL. ❑ MVE. 0 OTHER
OF
wows ❑ eLO. ❑ PLMS. .JR MECH; 0 M.N. 0 POOL
B. °11CTI(i,
VALUATION
SOUrCe LQjCT IC
8. �a
No. eel
No. Floor,
No. Room,
Roc. Room
CERTIFICATE (' Rea el
PI EXEMPTION
EWER
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
onside, and know the same to be true end cprovisions
correct. All Of laws and ordinances governing this
type
reverse p iL w ll he complied with whether specified herein or not. The granting of a permit does not presume
o give authority 10 MOM. or cancel the provisions of any other state or local I8N'-r49ulaling CBfctruCtiOG Or the
performance of construction.
DATE /D - 79 SIGNATURE
SPECIAL APPROVALS
DEPT. REO'O. REG
Env HMIM
Fire Mgrs..
Ca. Engineer
UtIIIl1N
ion• ClmNnce
SEPA Checklist
SPECIAL CONDITIONS
swrweJ-=L.-
nec'e. rot Rao,
FEES COLLECTED
Single S
SOIMing
Plumbing
Plan Check
SEPA
Mobile Home
Other IS.ea614
TOTAL Sly"
WHEN MACHINE'/AI (DATED IN THIS 1nr'.,•I
THIS BECOMES A PE HM I1
10`26-7'9
DATE %
04e *11.00
e11.00 » V
681.9P
10-26-79
P 6479
a;! I.1 0 a '
INSPECTION RECORD
OWNER
LOCATION
CONTRACTOR
TYPE OF WORK
N S E W FINAL INSPECTION:
SET BACKS
DATE REMARKS:
(k/J2e CA r M Ale 7 Tius c dN n ut,i/