1982, 06-28 Permit: 82A-5134 InspectJ00 A000
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APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
JEFFERSONNORTof ell T
APPLICANT: COMPLETE NUMBERED SPACESPRESS HARD TOMAKE 3 COPIES okra
S. 1!'C5 boll vol.
T LEGAL DESCRIPTION
°- (PARCEL NLAMER/1
ADDRESS3. 1GOE :roller*. Voradalo :!A
CONTRACTOR
,. 0000(1 Rtl :''rnrlago r.,^
OESIGNER
t nF10 S_rn; e..c
922-0693
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& �•t-nztOr r.:^o^sD ''D._LA
ADDRESS
&
CNAN cos USE FROM TO
99037
PHONE
_ 122-2790
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Actn. s t Rao.mot
Norin ISpolnSloe of ewe!
— SEE ATTACHED
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C1ERTIFICATE f Rea, Rm. I Rrot Rao,
N F
.EXEMPTION
I
Oht. Location lA MI FEES COLLECTED
eat... OOLITIC
Oornereep
I hereby certify Mat 1 have read and eaeminsd this appf cation end have read the 'NOTICE" provisions included
reverse side, and know the same to be true acorrect. AMI provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
'0 9Ne authority to riolate or cancel the provisions of any other state or local law regulating construction or the
Performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS .7
GATE OF APN,ICATIOTI ��{J -f"---
COD
ORATORS OF AIPLICa
SPECIAL APPROVALS
NAM( OAT
Co
a.
E. Che
MOM. COINIITICaaQ
O. ma
Plan Ch.ck
SEP.
Mob. Hunts
Other ISIMcihl
TOTAL E 20'60
rn
PERMIT NUratiEw
s�•z— w_-113+
04• • 2000
•20000,
O •SCC
5133!
06-21—C2
!
4479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOass A .AAL....
16/14/
OWNER
INSPECTION RECORD
CONTRACTOR
LOCATION
NSE W
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE
REMARKS:
J C�/17P42.:-.4"
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