1979, 12-07 Permit 79-8521 InspectYN�MpL �_
APPLICANT.
JOB ADDRESS
3apyr
CEEIOX[R
6' ACORES,
CHANGE Op DEE PROM
6.
APPLICATION/
TY BUILDING PCODESnDEPARTMENT
gp o HEll COUNTY ,.
NORTH Ell JEFFEASON / gPORgNE,WASHINGTON e9]6P I IbOEI lfiBaPJE
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
LEGAL. DESCRIPTION — SEE ATTACHED
PHONE
TYPE
7. Of y NEW O ALT. O ROTE. 0 RPL. 0 MVE.
WOR X 0 BLO. Q 0. Lry r.ECH: 0 M,H. 0 POOL
OESC H Me
6. lap 7 7 ro'/•
0AL T�o0 �•7at•SiS
soulw
Itiee
0 OTHER
PARCEL NOMBERFE
Sue or Perch
Tees Cone. Occuesnsy
No Floor
CERTIFICATE
of EXEMPTION
Zone Inn Iuuon
Eprineleree
OY.. 0No 0 Ruh.
Eu Idiot Ares In Ea 1•
I heleoy co, til he 'NOT II:L' lei Hions erTioded
.verse Y that 1 hay aed and examined this appllciuon and have 1S of and ••Iin211106 ypvel nln 1110
sid• and k e snue and correct. All Provisions O E
type of work^ow Me swill to be Aran `dohs, does n01 pros me
Will be COry1 i d will whether specified
1I0l1S ed herein rn nut. ih• wanting n1 " iI nc1011 111e
to ENO wJth 0ilY eo violate Or cancel ehe prov ISI011e 01 any other Stare of local law n.el �,i„,n ''
per/armerlce GI GORL1!U0403.
DATL /,f: 3141 /J �%
DEPT. 1a[CI�ALAPPROVALS
Torablenepp„,
' Cn SEPq\.
REC•O.
V ONAIIdNI!`/
SPECIAL CONDITIONS:
DATE //` - 0
P.c. Roam
fFESCOL1EC7E0
single 1
Bulldme
Flambe
Meth.
Pleas Check
SEPA
Mobile Home
Other ISPecitvl
TOTAL s
.7.00
.7.00 G.
8520/
11-29-79
6u79.
WHEN MACHINE VAL
HATED IN 1HVSSe0Cr ��ooiJ
THIS BECD?E$ As7n Qy 2I1 g F
! 1� V 7 - td I L l
OWNER
CONTRACTOR
INSPECTION RECORD
LOCATION
N S E
SET BACKS
DATE
TYPE OF WORK
FINAL INSPECTION: / g p h� J t"
REMARKS: