1991, 04-26 Permit: 91002106 MH SPOKANE COUNTY DEPARTMENT OF BUILDINGS
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W. 1303 BROADWAY AVEN&JE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit/application,state that the information contained in it and submitted by me or my agent tocc'l ile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPE1 LION 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 the provisions of any state or local law regulating construction,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.SIGNATURE ,p�� �� )
OWNER OR GENT kV a_ "V �� DAPEICATION, L�. / g
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ADDRESS : .S12'01KANE WA 99204
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`Ii.t. ...�.{.: % BY „JOHN LARSON
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SPECIAL CONDITION CHECKLIST
Project •
Address: Project# Use:
Dept: Date: Condition: Init: Appr:
(in) (out)
Dept.of Bldgs.
— Special Insp.Final Report
Hydrant( ) -- — —— -
—_ — Lock Box — -- — ---
Engineer's_ _ RID/CRP — — -- -------- ------ —.._._- ------_....__
Easements
Road Plans/Improvements
Bonds
Planning — — Bonds _ —_____
_—__
Utilities Double Plumbing
---- — ULID — — —
Other
'******************************THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY******************************
Date received for C/O processing: — _ __ . Plans pulled for final processing:________.____—_._________.___-.__--____.____
Temporary C/O issued: —.Certificate of Occupancy issued:.________
Office file review by: —. . Date:
Filed insp finaled by:__ _ Date:---__-- ----------.__—_._..
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: _ _________ Date:
Plans returned: __-- Received by: -------------------__---------------_--------------____-
No response from owner/contractor-plans destroyed: