1991, 05-03 Permit: 91002147 ResidenceSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY 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 perm it/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 or cancel tFaeIProvistons of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction. C
SIGNATURE ` �w � APPLICATION
OWNER OR AGENT ,.� -� DATE—
......... . .......... .
:,. •Ji' a: •�: •:x::11: !r r'st' :a'
SITE S0
ADDR
PERMIT USo-
PLATO= 0536.
BLOCK=
AREA- 00000000
!:#.....%ixS ..
OWNER= r :: : ., . .
JTREET- 1212 N W&
EY ACi fA'E:GREG _ __R
CONTACT
PHONE NUMBti-
B4I!_SNG CEfBPtK` 7RONT= . LEFT=
45
RIGHT=
: REAR=. :
'JS_ }iJ' i rl' •k''A• a$'M•. S' ik k ${• 1'' h'r •1G 'J{' :; ':::�i 3; •7{• Pi :'�•')4• i!.•'1{• �.' Pr 9t -fh 'P•
BUILDING
PERMIT
'1i �Jt• •1h i(• H.' j• •1C y1 •71• N: n' iFi )li .k 41: ii• ik ii: P: Pr 9k '31: 'Pr it '�: iS:.J{..1:.
CONTRACTOR= OWNER
?^'1'±l3
NE::'
N1::.;:
ADDITION=
I,;Ht•ii`Ni'rE I_J. i -1S1::-=
3?{...:?4: R3.! 1 .I. t.!'. ': 'Yl+.i-J %.l P
TYPE
VALUATION
------------
3528.00
1TEM DESCRIPTION
QUANTITY
FEE AMOUNT
.................................._...-
-------------------------
RESIDENTIAL VALUATION
--------
Y
612.50
STATE SURCHARGE
Y
4.
3t• 98 •Jt :ti -ly: •3+::,. a::tc Ja: k: •R•'P: •i¢ '31: •3i: 'Jlr :F: 'P• 8i• '31::`: 'il: 'R• :+': 'A' •P: 3:• 'A: PLUMBING
'•'`
P;_ , t. ; t _i T -3: i4'3k
'J4 'f'.'':!.• 'Pi 'lt• •1k '!: 'll' 'Jb 'Jt• 41' 9L• It: •3h ')li l if 'Pt 'P.• 7t-•-Jk'!i• t t: N::{::�.• 71: 'P:
Project
Address:
Dept:
Dept. of Bldgs.
Engineer's
Planning
Utilities---
Other--
Date'.
tiIities—_____—Other_
Date:
SPECIAL CONDITION CHECKLIST
Project # _
Condition:
— Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Bonds
Double Plumbing
ULID
se:
[nit:
(in)
Appr:
(out)
««*«**************«***««****«** THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OF OCCUPANCY ONLY
Date received for C/O processing:
Temporary C/O issued:
Office file review by:
Filed insp finaled by: --
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:
Plans returned: _
No response from owner/contractor - plans destroyed:
__ . Plans pulled for final processing:
—. Certificate of Occupancy issued:---
Date:
ssued:—__Date:
Date:
Date:
Received by: