1983, 02-07 Permit: 82A-9292 Inspect-4)wxER
APPLICATION /PERMIT
SPOKANE COUNTY o BUILDING CODES DEPARTMENT
NOR TN •II JEFFERSON APPLICANT: COMPLETE NUMBERED SPACES /PRESS HARD TO MAKE 3 COPIES
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EONIOACTOR
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ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
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ZIP
PARCEL NUMBER'S
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ZIP
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GRANGE OF FRO 0
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hereby certify that I have mad and e.� aimed this and have read the 'NOTICE" provisions included
on n side. and know e same to be true and Correct All provisions of law and ordinances governing this
tvpreol w. 444).5 gal be complied with whether specified Mr.in of not. The granlin of a permit does not presume
o give .utNRrih m .,date o c.mttl th. ooasiom of any other mate or local law regulating construction Of the
nce of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Oa TS Of AatleCATtONV L -8` R.)-- SIGNATURE OF APPLICANT'Y
SPECIAL AFFROVALS VECIAL COMAS.5K:
0.« C)x ❑ R .
mamo � Dew., 1 SARA.
e. I P,m Fa Paom.
No.
CEE %EM �TION. stood. ww . aeon's R I aw. wfaa Ww.a a' Loution (AN*
oreM O R,..,. 01
COCIE
NAME O.
VI
FEES COLLECTED
g ummy
Numbing
AA.r,
P lan Chuck
SEPA
Mople Moen.
Oln.r I5poofrl
TOTAL S '7-/5 .CV
�y2
ACHINE VALIDATED IN THIS $PAC
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR
N S E W
SET BACKS
DATE
TYPE OF WORK
FINAL INSPECTION: