1983, 03-25 Permit: 82A-7734 InspectRAN NumPER
10651 APPLICATION/PERMIT
iPOKANE COUNTY — BUILDING CODES DEPARTMENT
. Ronle au FFFFF SON y SPOKANE, wASNiNOTON Raao / I.al e64 -Tan
/OS AODRESS
APPLICANT: COMPLETE NIMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
'2113_4v,-;
�[[acv
DwNER 1
•$po1DC. Wit
ACT Pt RC II
A }
w_ r:nv_ CC
. w okanE Va.
ADORES/ ndiana - S•
DEaw NEw �.
LEGAL DESCRIPTION - SEE ATTACHED
ARC LNwaERPS
Fom
Ounaaner
lone classification
SmInipmed
OMing Arm In EO. Rabb.
ZIP
%Min P.m Upper Ftbor• Ost•g• Atm Sims.
CNANDE OF USE PORI
G(EW D ALT.D o,.. O Drool_ RK D MPG
T. woRN D .LD. D KIPS. 4 0 OTHER
DESCRIBE WORK
4 vALUATiON SOMVIE OAS ELECTRIC WATER
TIUT E
1 Mre W artily that I have read and examined t.e plicakan and i.j read tha "NOTICE" provisionst incl ded
on r aide. and know the same to be . , ORD goes. Edi not. 000nn of lien and ordinance:
this
Fgt. ofr w«k ado be ctlnplied with Wbethar wex:d Mr.n a not. Tna granting of a Permit rice, not Prewma
to 0,...,00w to .alae 00000011aale oen9 any Own ,tate or local awlatinglconstruction or the
performance of cawtrOction. SEE REVERSE SIDE F R REORRED INSPECTASR
l Ehr•Iling
of EXEMPTION Rabb.
�. OI+m Rn a`
CERTIFICATE
Lee -abbot IArml
SEWER�p0 Dy.N.r• D USE CODE
DATE OF APPLCATION 8-18-82 SIOJATUIE OF APPLJCAN
SPECIAL CONDITION.:
fFES COLLECTED
Single S
e .iaing
N umbing 5p
? re✓
Ran Check
SEPA
Mobile Homo
QN•r ISPwtyI
TOTAL s 14.00
m
PER NUMBER
zp
00• •1400
.14000
0 •000 0
7731E
09-01-82
f 6079
INNEN MACHINE VALIDATED IN THIS SPACE.
vpk,
INSPECTION RECORD
OWNER
LOCATION
CONTRACTOR
NSEW
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE
REMARKS:
4X 4- e-.- /2-r�
/ev / /2