1980, 06-26 Permit: 80-5189 InspectMnn grnan
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APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODER DEPARTMENT
NORTH 111 JEFFERSON 1 SPOKANE. wAONINOTON 00200 1 10001 001P0010
APPLICANT, COMPLETE NUMBERED SPACES - PRESS HAHU TO MAKE 4 COPIES
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LEGAL DESCRIPTION - SEE ATTACHED
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6WL Area 10.wmn1 Area Barer Area
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DESCRIBE WORK
VALUATION
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Belli Entry
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❑ 010.0. 0 no'N. ❑ RPL. 0 00E. O orNER
0 PLMI. 0 0100: 0 M.N. 0 PooL
No. Bath.
...Flews No. Roam
Rec. Poem
CERTIFICATE Braid.
el EXEMPTION
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ELECTRIC
WATER
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FEES COLLECTED
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I h.reby Certify that I have read and examined this application and have reed the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions 01 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
'Wo�TL''.a' authority to violate or cancel the provisions of any other state or local law regulating construction or the
pertONneMR �1 Rconsirucbon. ��.�nfIB��C✓�u��'''� � /I ��i't'I
OATS .00 SIGNATURE Ci
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IROVALS SPECIAL CONDITIONS,
DEFr. REDID. RECO.
Inc. 0101)11,
Fanning
PINK nlP.11
ERR. Clear.o0a
Building
Plbmbinp
Mach.
Plan Cheek
OEPA
Mobile Home
Ot rIe 0 •oI F15.50
Ip[RNITssNo—
DATE . Il P'OW� •�-il�• JS,
07* •55u
1550
.550E
•aoa'0
5188E _-
06-02-60
[ 6479:`
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W
SET BACKS
FINAL INSPECTION:
DATE REMARKS:
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