1983, 05-09 Permit: 83A-3679 InspectionAPPLICATION /PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 411 JEFFERSON E SPOKANE. WASHINGTON 50240 J 45001 4564475
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1. VALET M
S >J I /` 'tiu'11
2. LC 1 "1i L" 1 '.fP'4A1 Vim] A-114
3. T`' r 0-1 440.1 1..05E
AcJALVf,1
EaT O.
5.
oILENaE EXPIRES
�e I 77
PPKWE
PARCEL NO. 1107
LEGAL O RIPTION:
Ad,M Sacks F•K Y:
N.. h IS..
ZIP
PHONE
ADDRESS
ZIP
S... OF USE MOM
110
8_
TYPE 0 N W 0 ALT. .01-DIN. A/
DIN. 0 RPL.
7. OF BLD. 0 PLM8. O MECH. 0 M.H.
WORK
w Owe
we
than
Ov. Ow Olisse
1Tea
1,0,.`J000. -o; 1..-
1
O PAVE. O O
D POOL
THER
N. boars
Se. 24.1 ¢.P. nn. R»..
wN. amenww
M. OwIlInsa
104
8. pESCNaE _ I
9.
�cei MOI
sO.NNY 1 OM 71 El-ELMS
Ses0 M. APO..D
1104 Port
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E�EV°f.En Ei
I hereby oertlly that 1 040• read and examined 177). applleetlon and new mud the 'NOTICE' 710771.10774 InC1U0.4 on
w 410.. and Imo* the tame 10 M tru• and coerecl. All provl41one of law• and erdInancw pov4•nb9 this typo of
we. .RIG compIl.d with .0•77741 49.0111•E herein or not. TM 9ranlln9 of • 9•1011 d0.4 rot presume to 9100 au.
17.0,110 b 0101.14 a cant.? 104 provisions of snr other state of beet law recu41109 conetructIOn cc the performance
04 constr.-Non. SEE REVERSE 510 OR 570015EO INSPECTIONS r
SIGNATURE OF APPLICATION J
OWNER OR AGENT DATE
SPECIAL APPROVALS
1.IE1N. FINAL DATE
insmw
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
- �.Pt Gt.AN6.. 4)01 B DR. •
4plx f'L'C. 7),Va. [L
P/4.44.7 p • d�-y,.,/./09.1/7, ✓y
PERMIT 15 MONT
FEES COLLECTED
441405
0.0,0025
0., Ova
1
TOTAL S 15C,
�FERM1T NUMBER
83A Scn
•15600
•15600E
A
36773
C`- -05 ,.3
6479
WHEN MACHINE VALIDATED IN TH15 0P�`
)DRESS
DISPECTION RECORD
\TE REMARKS
5-9- r7 c
//- 893 0
/.43
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