1992, 05-04 Permit App: 92003040 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit/application,state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same.All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not.I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PHUULi: i APPLICATION DATE- 05/04/9-'2
PANATTF:7: RF. 1
ET:IL 1 :37H AVL
ADDREEE- EPOKANE WA 99216
PLAT4- 00275:7, PLAT NAME- VERA
AREA WIDH=
OWNER- WARNER: KIM PHONE-
ETREET- 1 :3403 E AVE
ADDREE - EPCi<ANE WA 9926
PRONE NUMBER- 509 922
ALiA;AY PHONE- 509 922 O50c.:
ETREET- PO BOX 141562
ADDREEE- EPOKNE WA 9921
ITEM DECRIPTION OUANTITY FEE AMOUNT
•
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWTW,
PROCEEEED EY : DOMITROVTCH , ROBIN
PRINTED BY : DOMITROVICH, ROBIN
CONTRACTOR OR APPLICANT IE TO FIELD LOCATE AND CONFIRM Th-ff.7
THAT THEY ARE CLEAR AND UNCEETRUCTED
FOR TNEPECTION PRIOR TO COVER Y::k*Kkk**:kK
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