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1981, 04-16 Permit 81A-3630 InspectSOURCE CITIES 'PLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON S ISSO / 16001 see -MS APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES OE ADDRESS 1. N.Z215 IiA.E01BTd kO C'IDLE111AN1S S1J$01 UI SIoM DW ER Ttrees-1 L. ;••••EKE • ADDRESS N121.15 e.LJLEWIAAJ CONTRACTOR S/Rua S, ADDRESS yRHf DESIGNER ADDRESS CHANGE OF USE FROM . ITO 7i isHoNE GTL-tba5 E n�aI�P� PHONE ZIP PHONE YIP TYPE IL NEW O ALT. l AO'N. 0 RPL ❑RAVE ' WORK Itl BLO. ❑ FLMB. D MECH. ❑ M.H. 0 POOL DESCRIBE WORK r�� & OQfl&%lio R Aooitionk TO L'DIDEur..6 VALUATION lL*432.DD I hereby certify that I have reed end examined this appllcalion and have lead the "NOI WI" I,.wlslons Included on reverse side, end know the same to be true and correct. All provisions of laws and governing this type of work will be complied with whether specified herein or not. The granting cal dons nor presume to give author ltv to violate or cancel the provisions of any other state or local law IegiilaInn r:nnirucnan 1.1 the Performance of constoaCtinn. SEE REVERSE SIDE FOR REQUIRED INSPECTION GATE OF APPLICATION 7/ SIGNATURE OF APPLICA SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE 0 OTHER LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBERS IZ5 S4-3b3 c uM Set 9en0f In Feet Normsoma 55r East 'Walt Size of Parcel zone ClasnnotIon wox i AC, 4aw81oao *ed Tyo Conat. I OuupmsY -m R'S wmam.d Yes Orm 0 Req'd. Bungles Pros In so. Ft. Y•T4on .112 .or) Main FlOOT Upper Floors GMuo Arm IDSgrage Arm of Oenxa I Flnlesu easement I Min. S Mment No. MHOS I No. Stories I No. Room. Igo. of Dwain.. CERTIFICATE RHO. Keep, P1019u'e. of EXEMPTION I �1// OAS ELECTRIC WATER ,..• 11tII. e . onN1TT SEWER 5E91t4 Enum. Dist 'Location (Arm) USE CODE Owmrmio Public D Prin. N FEES COLLECTED $1 61 E$F Building T 1D•Pa Plumbing Mesh. Plan Check BEPA Mobile Homo Other [Specify) TOTAL $ .10.00 WHIN MACHINE VALIDAT.D IN HIPS SPACE. Tuln RcrnMla APERMIT • 100 • 1 000 8- •1Q008 •000 8 04-15-81 8 6449, •'.r•,••r i ADDRESS INSPECTION RECORD DATE REMARKS 1