1980, 11-03 Permit 80B-0474 InspectAPPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 961a0 / 16OP1 a65.3676
PERMIT NUMBGR
Po a- 0`�"7'f
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
lc ADDOR!/ESS�P o,�/�y
1.i1
LEGAL DESCRIPTION -SEE ATTACHED
LAC JEOIVIathf
2. I
PARCEL NUMBERS y/`3.ai—�,Z,0
Ni .tars y-/o 13LLK3
DP
M7/nu/AY AcY
g 4o 1,4_
55
E
928-3173
P JAa-
'
9204'
Actual set B9In Pot /
North /s Soatheb Eut - Wrest z�-
I�v
/// L,,an,/
ra
C9NTRAC0
`04'44-
PHONE
Slm al Parr
.2!zn. Nir
4.
ZIP
dil
Type Canrt. 0ttoom
Oer Ono ❑ Rea'd.
R
DESIGNER
PHONE
bonding Ares 15,So. Ft.Vg�('
T6
6' ADDRESS
ZIP
Main - oor Upper Floors Outgo Arm Stogie
• CHANGE OF USE FROM TO
e.
Area of ooxs I:IlI)h! em nl UnlIn. Bassmenl
'.y�,Lfo� FiA.(.�L
Tor VPE - 0 NEW 0 ALT. 0 AWN. 0 PIPS-❑ SAVE.i. w5RR BLD. ❑ MM.; ❑ MECH. L@ M.H. ❑ POOL OTHER
No. ammo mmo no. storm Ho. Rooms INo. of rellingr
CERTIFICATE Rea'o. Reed. 301 Read.
of EXEMPTION
DESCA C. RH
on lANs)
Enum. Dial LorUS
FEES COLLECTED
SI gle $
2A ATIOry SOURCE OAS ELECTRIC WATER SEWER
0, s ds3 UT CITIES�
Ownersnlp USE CODE
Public OPrlvele
I Itersby certify that I have read and examined this application and have read the "NOTICE" provisions included
on arse side, and know the soma to be true and correct. All pluvlsions of laws and nicknames governing this
type of work will be complied with whether specified herein .I not. The granting ul n peen not presume
authority the SSIDE of any Other D I S ECTlocalI w rpgy nstr motion ur the
SEE REVERSEESIDE FOR REQUIRED INSPECTID )
# �=
BOII7In0 .6I
Plumbing
ns ructio .or
poglue
performance of construction.
DATE Of APPLICATION 9—A�% -J Q SIiNAFURE OF APPLICANT
Mall.
SPECIAL APPROVALS
NAME DATE
SPECIAL CONDITIONS:
/�
/4.Q � f ryn
/+ �p
•
-/,//
t
Plan Check
SEPA
I'N
�JJJE-1.�y
Psfnnl
Mobile Home
el .
ISPetllyl
. Engineer
Other
Lillis
06
TOTAL S SO --
07e 'u50O. ,.
o500 G
G7.3R
09-18L80
e 6479.
INSPECTION RECORD
OWNER
LOCATION
CONTRACTOR TYPE OF WORK
NSE W
SET BACKS
FINAL INSPECTION:
DATE
REMARKS: