1991, 04-08 Permit: 91001635 MH•
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99700
(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 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 OF n APPLICATION / 5
OWNER OR AGENT( icl l� DATE
Project
Address:
Dept:
Dept. of Bldgs.
Engineer's
SPECIAL CONDITION CHECKLIST
Project # Use'
Date: Condition:
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements
Road Plans/Improvements
Bonds
Planning Bonds
Utilities
Other
Double Plumbing
ULID
Int Appr:
(in) { (out)
.....*************************• THIS SPACE FOR COMMERCIAL PLANS TRACKING, CERTIFICATE OF OCCUPANCY ONLY
Date received for C/O processing:
Temporary C/O issued: Certificate of Occupancy issued•
Office file review by: Date:
Filed insp finaled by Date:
Plans pulled for final processing•
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: