1981, 01-28 Permit: 81A-563 InspectAPPLICAT1ON/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTHEII JR PP Broom I IO..., WAS,. IRO Tor...o / leoRI wag re
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
Z
OWN(a
a I � .I Olde Q C.MD t3 %3
MI
5.25== "FLARE
CONTRACTOR
4 Swrnf:
ADDREPS
5p6r46
DCfIONER
a 000RETB
C.Vwoto. use 1ROM
LEGAL DESCRIPTION - SEE ATTACHED
•ARCeL Nw10ERn
n rorra
QM -2070
zv
/41441 fa 54404
Not4 104414
Ma. of •.rel lEens ...mo on
ZIP
TVP. C44LL
O4.a..Mtr
Oyw ON. 0 RN,.
• NON(
0414.4440 IEuldh. Ales NSA. M.
MO
Nan Frew
0n Mow. 1 On.T. ANN
1.101••.
100
0 ALT. ,❑ Alarm as, 0 uv(.
'• y.ORR M D. 0 RAM. fp M(CN. 0 Wit 0 POOL
❑ oT..R
A,N of 0.cnr Flmnr.a bN.To.I
04,40. Salmon!
'R d1.w
No. Ran. 1 ha SINN NA Ream. 1101. 444 0 40108
CERTIPICATO ha. I Roca. Plot Am'e.
0* EXEMPTION
` C4CA.a WORN
v L r N &Dolma YAP I ELECTRIC
MITRES
1 110.0, ..only that 1 have read and IlhErninn1 106 application and have read the 'NOTICE" 4404 4004 included
.1 tetar. 40, and know the unto to Oa Cue end correct. All pro.11lona of laws and n•drr..An **venin( chi.
Wp. 01 work .ill M cwnpll.d with wheth4 &p.oified h0rain or not. The granting 01 a primal dm rlol prawn,.
. oil.• autho'Ily 10 vidata or tants Na provision, of any oNar 444. or local law .Yulati0y ton.trotton or
lwlunnanc. of camnhrtGon. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
CATE We APPLICATION //16 %SESIGNATURE OfAPPLICAO/
(num OM.
La.11on (0/441
w
&CAME
Oww.rmis 1.E COOS
no. OPrwl. 131
MC/AL APPROVAL( 40ICIAL COI4DITI0al41
0R.r( own
A♦PfNMi(n• ow. A..+� 1•
NO.E*EA.r
%wow
*1044. (..mNN
FEES COLL(CT(O
104.10
L ull••*
Pnen4.na
4$1_.._.
1.
Noes.1 ,S}�
Plan Puck
E GTA
MAIIR Noma
Oils (EONl1y1
TOTAL S Od
06•
•17.00
•1700 1
5621
01-16-1211.
1 6671
r.(.
WHEN MACHINE VALIDATED IN THIS SPACE.
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W
SET BACKS
FINAL INSPECTION:
DATE REMARKS:
/-2/ 6J ' A.M.
t