1991, 07-12 Permit: 91002851 MHSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 13153- ROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
1 certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate orcancel the provisions of anystate or local lawregulating construction, oras a warranty of conformancewith the provisions of any stateor local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE M
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ADDRESS= LIBERTY LAKE,WA 99()j_9
PERMIT i,i E::- R!::Pi...At::E XIS'i iNG : WITH "t'--J "OtiI - HOME
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AREA= !;,�,,�;,'t ty�;,t:it., I.. , �. = F• WIDTH- .! i f DEPTH= 85 :;. , =:
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F1iiiN1� Ra:. AIKi::.l`i, Ii...fl - PHONE- 1509 926'3538
STREET= i8610'E DALTON AVE-�.
Aiij;Rl.. S,= LIBERTY i-.lil4C:.. it A `?' YP-! .
CONTACT NA!'' E= .Li.. A taI is N .._ P'rdF-ii' E ytf.:iMt: i=.i1 '.:>09 926 ,h� 0:1
ist.1Ii..DING, SETBACKS: FRONT= 3W -LEFT=-24 it?:GH'f':.. 5--' REAR=
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'CONTRACTOR= —OWNER 'P r'i ':' i*. E --
YR/MAKE= i 99i MODEL=
AERIALO= +A I DTH= 28 LENGTH= i'{..i:::: 56 HEIGHT=. i iii
DE:tit;RIP T .LON QUANTITY FEE i-. AMOL.iNT
INSPECTION FEE i (y % +. 0
STATE A-1(E ,: Ul,•:f;HAFi rl:: Y 4.50
COUNTY v .;:l.t c+ ,"!.':7''
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PAYMENT-SUMMARY
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i-'A'Y`i~li:"NT DATE RECF::i:P T O PAYMENT AMOUNT
:
TOTAU CtF:.00 TOTAL PAID
PERMIT TYPE ... i-'F;,F;, AMOUNT AMOUNT PAID AMOUNT-OWING.
--------------- -___......................_...`.......... —------------
MOBILE i ..1 t 1 E i"' M � 2 ....20.50 -100. ,
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i20.50 Q0.50 inti
PROCESSED BY, JOHN L.f`iR, ON
"THANK