1991, 10-10 Permit: 91006722 Remodel 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,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OFA _p ,,,_J„ DATE APPLICATION lO —
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OWNER OR AGENT avAcw 0,,"""Ip.c
?.: .;:t..3..3 L:.t.; { NUMBER= 91006722 ISSUED PERMIT DATE= 10/10/91 PAGE=
01
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SITE STREET= 5713 #::. 15TH A k`E e'1^i#z:(.:?...l...•Ir.. 23534-0906
A:(i;:;E:.E::::sS:::: SPOKANE WA 99212
PERMIT I..I;:•'I:::::: BASEMENT REMODEL
PLAT4= 003336 PLAT NAME= SLOANE ADD REPLAT 41
OF S 7 l.. ::.... :H. D 1A1?::.?...?....?.N t Y x.?:::: WATER ... S.::i ? ... .r. CO WATER DIST42
OWNER= '1ii"i _i,1tifi,j HOMES
...0 1'I..IONE:.:::: 208 772 7581
STREET=i•::. :s`' 9 i LOCH HAVEN i:,;,
ADDRESS= HAYDEN DEN LAKK f:. ID 83835
CONTACT NAME= TOM ANDERL. PHONE NUMBER= 208 772 7581
BUILDING S. " nf < : FRONT= NfLEFT= NA
RIGHT= NA REAR= ` A
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CONTRACTOR= SHOR 11 O i , HOMES ? Ni TONE= 208 , '2 7581
STREET= 8191 LOCH HAVEN DE;,
ADDRESS= HAYDEN LAKE IN 03::535
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(`?I.!.= REMODEL= x ADDITION=11:(,:ij'v:.: {.t••?fi!`•ii';•E OF t..!:`:-?::=
O W i::.1�•..I... UNITS= i i.;(.:(.:!.E#=' , I...s::: I. L D D G." }4 t Y I':::: STORIES=
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,.;E i_' PARKING= :H.1•-1 t t N I J.{.t_:Lq#":::: CRITICAL MAT= I'd
DESCRIPTION( .I.[:iN t.•,R(«i1UF' TYPE ,E€i FT VALUATION
REMODEL R-3 VN 500,00
ITEM Et"t DES(C:R:E.#=TlO#J QUANTITY FEE AMOUNT
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RESIDENTIAL 35 . 00
' i fi t'E:. 4.Ii':i.:I..I"fr•�(x?. �Y' 4,50
COUNTY' SURCHARGE
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PAYMENT DA t E R#::.t.:E.t.I"T:n, PAYMENT AMOUNT
10/10/91 7534
45 , 10
TOTAL DUE= : :0 TOTAL 'a. t: 45, 10
PERMIT TYPE:: FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 45. 10 45. 10 ..00
45., 10 45 00
F'E ff f: :`.>F:T) BY : JOHN LAR'SON
PRINTED BY : ..IOHN LARSON
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