1991, 05-09 Permit: 91001925 MH SPOKANE COUNTY DEPARTMENT OF BUILDINGS
VIS. 1303 BROADWAY AVENUE
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 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 or cancel visions of any state or local law regulating construction,or as a warranty of conformance with the rovisio s of any state or local
laws regulating constructio .
SIGNATURE OF APPLICATION % c(1
OWNER OR AGENT C1%7(
'� / DATE
. .
I' * .
SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition: |nit: Appr:
(in) (out)
Dept.of Bldgs
Special InspFinal Report
Hydrant( )
}
Lock Box
--' ) --
-- --� — { --'
Engineer's | —_ | __ RID/CRP
Easements
_ --
Road Plans/Improvements
- _
Bonds
-- --
Planning Bonds
__ -_ 8onUn
--'
-_|
--'
Utilities Double__ Doublep1umbing
ULID
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Other
- ' --
~`^~^```^~^```THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OFOCCUPANCY 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 afteC/O issuance:
Owner/contractor called regarding the return of plans: _ Date:
Plans returned: Received by:
No response from owner/contractor plans destroyed: