1982, 01-04 Pemrit: 81A-7900 InspectADDRESS
DATE
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' SPOKANE COUNTY — BUILDING CODES DEPARTMENT
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NORTH 611 JEFFERSON /SPOKANE. WASHINGTON 98250 / (Seen 466-0876
WORN
of EXEMPTION
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
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OWNER
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RAYMOND SPo E- 9 (i"
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CHANGE OF USE FROM ITO Are or eck I Flm•ee Ba•emenl Unsenerne.,
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WORN
of EXEMPTION
DESCRIBE WORK Enum, Oln. 1--ra n (Anel
FEESCOLLECTED
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VALUgT10 SOURCE OAE ELECTRIC I WAT[R SEWER Own. ani USE CODE
UTILITIEa P4D11° �•" O
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I hereby certify that I have read and examined this application and have quad the "NOT ILL•' nl no, included$.
on era. aide, and know the Mme to be true and correct. All prneislnns ut I.W. ani ��i T,-,'rs gov eming this
type of Work' Wilt he Complied with whether a—thid herein or not The granting nl a "of pl esume
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to glue authority t. elolate or tenc.l the provisions of any other state or 1-1 law ��•�I„I. - n ,�,nsnuchon e. the
performance of eonstruotlon. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
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SPECIAL APPROVALS ECTAL CONDITION[:
NAME DATE -
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