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~ SPOKANE COUNTY DEPitnTlIAENT OF BUILDING AND SAFETY
W 1303 BR4ADWAY-AVENUE
~ SPOKANE, WASHINGTON 99260
~ (509) 456-3675
I 1 cenftythetlhaveexemfnedthisqermiVapplicat(on,statethetthemformatloncontalnedinilandsu0mittedbymeor myagenttocamplteseidpernrtiVeppticatlonislrue
and correct, and aulhorize Spokane Counly to proceed with proaessing in addition, I have read end understand Ihe INSPECTION REOUIREMENTS/NOTICE
provlsions Included herefn and agree to comply with same All provfs,ons ot laws artd ordinences governing this type of work wili be complied with whelher specHted
herelnornot I understand that the issuanceot this permiVappQcallon and anysubsequent inspection approvals or Certificates of Occupancy shall not beconstrued to
give authoriry to violete orcancel the provrs►ons of any state or local lew regulalmg construction. or as a warranty ol conformance with the provisions of any etateor Ioca1
laws regutating construction
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
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