1981, 04-03 Permit: 81A-2988 InspectFAN NUMBER .
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PSAMI7
APPLICATION/PERMIT
BUILDING CODES�DEPARTMENT
SPOKANE COUNTY -
JEFFERSON / SPOKANE, WASHINGTON 9a2.0 / MOO) aaa-aeTs
NoRTH Oil
IES
APPLICANT: COMPLETE NUMBERED SPACES — PRESLEGALD�RIPTION -SEE ATTACHED
03•
.9.00
.9.00 6
.9.0011
A
29574
04-0C1
1647
.000
O[e1GNER
CHANGE OF USE FROM
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TYPE U�e; 0 ALT. L7 AWN. ❑ PPL
7. woRK 3 ala flarKi.set. ❑ MECH. 0 1•1 H.
LEC T RIC
®® 13. etre Aro• 11.01
Stem •
FEES CTED
❑ MVC. 0 OTHER
0 POOL
E. h$ — —_ 901ICF- provisions Included
I hen by c rely thhatII have read and examined this application and haw, read the " governing this
e aide, and tmow the same to he true and cornet. All Provisions of laws and •,ulinancestS not 0n oI the
type reverse
work will y complied with whether specified any other stepin or not orlocal law orey.I nriirnit
coin rucot presume
p give authority fl violate or cancel the SIDE o
rformenca of construction. SEE REVERSE SIDE FOR REQUIRE
SIGNATUR
DATE OF APPLICATION. -i-----
SPECIAL
CONDITIONS
Singh S
Building
Plumbing
WM.
Ran Chock
SEPA
MOEN Homo
HEN MACHINE VALIDATED IN THIS SPAC
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR
N S E
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE REMARKS:
�v �‘47)