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\ SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY iJ--
W. 1303 BROADWAY AVENUE
' SPOKANE, WA8HINGTON 99260
(509) 456-3675
I certliy that I have exunined this pormit u►d state that the Inlormatlon contalned in k and submitted by me or my apent to compiie aaid permit ls trus and correct. ln
additlon, l have rosd and understand tM INSPECTION REOUIREMENTS/NOTICE provitfons Inciudsd hereln and agreeto comply wlth same. All provlslons ot laws ~
and ordinancss powminp thla type of work wlll be compllad with whethar spocified harein or not. I undsrstand that ths lasuance of thia permlt and any subsoquont
inspecUon approvals or Grtificatea of Occupancy ahall not be construed to pive authority to vlolate or cancel the provisions of any atate or local law reyulatinp
construction, or aa a warranry of conformancs with the provfalona of any atata or local lawa reyulatlnq ponstruction.
SIGNATURE OF APPLICATION
OWNER OR AOENT nATF
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ADDRESS= PO:i: EC :C TJ 83726
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