1984, 01-25 Permit: 84A-469 Inspect n1SPDCTION RECORD
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SPOKANE COUNTY— DEPARTMENT OF BUILDING&SAFETY '` ^q
NORTH SII JEFFERSON/SPOKANE.WASHINGTON WORN I(SOEI afbSSFS
APPLICANT:COMPLETE NUMBERED SPACES—PRESS HARD TO MAKE 3COPIES
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age LEGAL DESCRIPTION:
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9. .141.0.74.. IIRI.: vo �oV ......wN.,- FEES COLLECTED
I Mows certify INN Mw road end MamIned PMN application and Mw rap 111.'NOTICE'provisions Included on
wwry side.end Anew NH maw to M Rue and most.All provisions 01 laws and dO ea governing this typo of Aallq �[.r
wore rM pe aamplsd wile AMINO apse..MANn s not.TM Droning of•permitNOdpes nod prmume lo glw aV-
parog Ir•l$0.a r...of Ma provlslaas et My senor Nates pod law regulating sonN.sstlon r MS p•flrman. \)......_...(„2
nrw�y
of mnsugOlon.SEE R E_E SIDE FORK 11R HOPE TION.
SIGNATURE OF 1. n_' APPLICATION es,r
owu ER OR AGENT :II DATE 1-Cl/ "/ r�`r'.
SPECIAL APPRIRVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE) twow
.MLw. SAL PATE
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..... 32—c,
TOTAL S ws
Sp, WHEN MACHINE VALIDATED IN THIS SPACE,
0E10410 IS NONTRA NSF ERA OLE THIS SECOMES A PERMIT.
sr+ ,frii PERMIT IS NULL ANO VOID IFWORK HAS HOT COMMENCED
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