1983, 01-25 Permit: 83A-627 Fire Damage RepairPLAN NUMBER APPL ICAT ION /PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON I SPOKANE, WASHING70N 952801(509) 455-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
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3.
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PUBLICO
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TRA O I
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LICENSEE%PIRES
PRIVATE❑
Naed Parol Zone Clesiiration
Oprvdix
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
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work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Buildup
4. 0qR
Ale
SI�LZIA
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jlp
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SIGNATURE OF APPLICATION
Oq penyy
IZ'h
OYs ONa�ORW'tl.
5.
ADDRESS ZIP
8. CNANGEOFUSEFROM TO
TYPE EJ NEW
NEW .F') ALT. 71 AWN. El RPL. ❑ MVE.
7 OTHER
WORK -L1 ``LD. 0 FILMS. O MECH. ElM.H. ElPOOL
8. DESCRI%IFri rAoh"-� F2Aif-
Floor
No. aNM No. Flops No. Fin, Fbeme W. Dx & lry
Oaft"Lofas"PL RarylMtl Ys0 NoO Murton,
or Ypiono, Rxel Y®O No0
Slprell.fFlootl H. M. Ibeulratl0
Y®0 Not APPlk.0 Recalwo! 0
VAWATION
SOOUFCE
GAS
ELECTRIC
PUBLICO
S ICGO
OMNreMP
FEES COLLECTED
.�C
IRILITIES
PRIVATE❑
SEWERO
Publk❑Private �
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
C/
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Buildup
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR RE OUI ED INSP TIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER ORAGENT
Me
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM.
FINAL
DATE
G `�IY LAC- � G -vo ' � r • I ' 2I
K K. Yj
Plan Chock
Env. Health
SERA
Planning
M/
MFG.FG.Horne
Fire
RMM,
O1MrISRe011y)
to
Epinep
Ulllltlm
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
Rana
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
01-25—si
mh
DATE ISSUED
PERMIT UMB/ER^
lfJd-
62.721 A156000,�
PERMITNO. TOTAL