1983, 02-08 Permit: M82B-2211 Inspect rPLANNUMBER APPLICATION/PERMIT PERMIT NUMBER
I SPOKANE COUNTY— DEPARTMENT OF BUILDING&SAFETY I e}2--reii—:.21!i
NORTH III JEFFERSON(SPOKANE,WASHINGTON 492601 ISO9I456-3475
APPLICANT:COMPLETE NUMBERED SPACES—PRESS HARD TO MAKE 3 COPIES
&Me•DOREss 18012 Auguste PARCEL NO.
105 MOCK r wew•l5ww LEGAL DESCRIPTION:
2. . yl •
PHONE elerlo T13r id'', 929
7924 ku 'e 3. area
,..R,..D•00•43.S. 6. 18E22 August• pp Po.M1.... E I.*,0para•cTOa Valley F•irevl ape lsorE 1(1`83 922E 2760 LAN Pea b..C 'ee.•>, I Rc ZIP
E' •OOnEss ■• .C.a
6. 16E10 SDre� ru
ue Ave. 99057 `''''''' Dyog 177«`•4 ORNs, •.-,C(C
DEPONEP rOARle, ., ..KME ...col.vw„wa. law.ma..v..,aw. I saliva...•... •c::ll('.1
S e at or 1:0.VA r,. I
ACONESS„ p �: .~.Ga. ppP..F�• IONS.,Sr,R gyp. ._
TYPE aTNEW O ALT. C�AO'N. C',PL. O PAVE.
' 7. WORK 0 BLO. C PLMR.i'I-+ECH. C M.H. 0 POOL O OTHER `HIaiEN.p. Mo.,. VA0 Motor'or
pE1CR,SE wORR Install'Blaze Princes•" stove, nodal IIJ 20d aewi.a.FNmw.we - Y OR,,.�O
8. _ y.t>_ i,� - R o.3 V F.��ra�.lF9�atar..c TieY, ywD MA _
vuu•rw.. I t Ea a I EIEDTRK *EO p 0...,��O I FEES COLLECTED OP
B. .,om,fy Mat■nave read and examined Inie application and hove read the•NOTICE•Prov eiOns Included on
and anew IM.5.7 10 w Ir.and correct.All TV.57..PI of end ordlna..T 0ov..ning tag(yob of evi,exp
57010 be complied Alh ahem..specified ea., ce not.TO.Ol•(3*T of•w e,.dm.nd Preume to give au-
.y to viogle SEE Le.EV 5e *FOR of any 0550 N•H 7 TIO gw rpulallnp construction or the performance ,
Or consirucl..SEE REVERSE Si SI FOR RE IRED INSPECT. 3 M.N..
SIGNATUREOF /y ee�„.. APPLICATION q_2,_� ./
OWNER OR AG - GATE (
,J.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PNELNA FINAL PATE
•
SEIM
OPr to*,
onaLm
•
LL
TOTAL S
WHEN MACHINE VALIDATED IN THIS SPACE,
INSPECTION RECORD
•
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NS E W FINAL INSPECTION:
SET BACKS
DATE REMARKS:
— ex3 rtev/vo,,vt.,
r
/ -. ,