1984, 01-17 Permit: 85A-5604 Inspect 1
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DISPECTION RECORD
ADDRESS
DATE RAS
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ANNUMDER APPLICATION/PERMIT EA .
_, SPOKANE COUNTY— DEPARTMENT OF BUILDING&SAFETY I s�A u SG,o'4 I \
w NORTH III JEFFERSON I SPOKANE.WASHING TON 117.011501.5
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APPLICANT:COMPLETE NUMBERED SPACES—PRESS NATIO TO MAKE 3 COPIES
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I may artily that l have reed and.eemined MN application end have read the'NOTICE.provisions Included On
mom.side.and ked.101 am.1011,01 and=H.01.AN 000TI.IOns of laws and ordinance.p000rnlng IAN typ.e1 2y.--
nom.111 D.no.590..with.hat.0.adN.d herrn or not.The granting of•Forme due not pr.eume to give IV- ni10Yp
.orny to v1d.Ie or an.tllS provl.Nna M any.Nor or oral law regulating oen.truclbn or IM p.rlam.nc.
M wlaNudbn.JEE770::10 R REDVIRED INSPECTION{ •N.e.. _
SIGNATURE OF /UM,�� J()1J')7 APPLICATION p7
OWNER OR AGENT (Y(•(J J(/O�/I.A- DATE IIfMR��o 7 I Nlri. .....--- I.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
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Nor. 1269 +yF^ IqC 1I�qn.. VSOW TOTAL S ZL�NM /
I WHEN MACHINE VALIDATED IN THIS SPACE