1981, 12-21 Permit: 81B-2915 Inspection CardOWNER
INSPECTION RECORD
LOCATION
CONTRACTOR
N S E W
SET BACKS
TYPE OF WORK
FINAL INSPECTION: 3--r-R-3 , �(
DATE
REMARKS:
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APPLICATIuN /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 011 JEFFERSON / SPOKANE, wASHINOTON 09.0 / mo.l•00-3676
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
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2.
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CONTRACTOR
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DESIGNER
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PERMIT NUMBER
LEGAL DESCRIPTION - SEE ATTACHED
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• of Parcel
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Typo O.. I 00EUPancY
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CHANGE OF USE FRO
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DESCRIBE 'NOAH
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No. I No. SI•.N.
UMW. ea
o. el Owsl.nos
CERTIFICATE
of EXEMPTION
S. AO S F • .. ol. L 'Lou
. IA,.
vnLD n IN SOURCE GAS ELECTRIC WATER SEWER usE coDE 9. LITIFIFT■ wen O w N.
I hereby certify that I have read and examined this application and have read the 'NOTICE" provisions included
reverse on side, and know the same to be true and correct. All provisions of law and ordinances governing this
typeof work will be complied with whether specified herein or not. The grantin of a permit does not presume
to give authority to violate or cancel' the provisions of any other state or local law regulating construction or the
performance of construction.
.Sa ri REVERSE SIDE FOR REOUIRED INSPECTION
DATE 0E APPLICATIOI.Ljp — P I— i SIGNATURE OF APPLICANTA T
SPECIAL APPROVALS
APACE OAT
•
Fmk. aaaaa
SE PAC
SPECIAL CONDITIONS:
A... I .. P rPt R..b.
FEES COLLECTED
5'.010 S
Building
M.Eh. * 17.00
P. Chock
SEP.
Mobil. Hem.
Other (Specify)
TOTAL S
04• •1700
•1700 7*
•17000
F
•000 0
291.49
12-21-81
9 6479.
WHEN MACHINE V•L MATEO IN THIS SPACE,
THIS BECOMES. PERMIT,