1980, 06-03 Permit: 80-5295 InspectINSPECTION RECORD
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OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSEW
SET BACKS
FINAL INSPECTION•
DATE REMARKS:
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APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH E11 JEFFERSON / Pox ANI, WASHINGTON IR MO / MOH a14S211
APPLICANT. COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOE ADORES..
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AOORESS ZIP
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LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NURaalR/1
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ID of Percy.
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03• 30,P
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57942
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❑ MVL ❑ OTHER
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OESCRISI tED0.1s
CERTIPICATI
of EXEMPTION
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En.. Hon ural
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I heresy certify that I have read and examined this application and have read the "NOTICE" provisions included
On revere side, and know the same to be.1031 vet correct. All provisions of laws end ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other slater or local low Paginating eonstruotlon or the
perlOr,OOnce of construction. SEE REVERSE SIDE FOR REOUIRED INSPECTIONS
DATE Of APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
1.10. 1.1••
001E4
SPECIAL CONOITIOM
No. Rsomt No. r 09.111nx
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FEE.. COLLECTED
3041. $
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ERWIN
Mich.
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$ EPA
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TOTAL S= ✓ i