1984, 01-09 Permit 84A-174 Inspect.417/541:7UMRER 1
APPLICATION/PERM IT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH all JEFFERSON J SPOKANE, W ASHINGTON PPMM 1 ISOPI a5e-Mr5
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
lr./.7.49 PEsa
mac. /1/ C�c,/o,� �,d
ion, I BLOCK
5- a0OPEM
E19_Vao2)
PARCEL NO.
LEGAL DESCRIPTION:
Sue ol hr.
name.
gocupara
Now m._
1-
bR0.1lel1. I
Or. a'ow�O D
A... Vol.., I Mal 11 . okra
ZIP
o..NdE'„w.lo.. , 1T -
s `'
TYPE ❑ NEW ❑ ALT. ❑ AD:N. R RP1.. O NNE.
7' WOPK a m.o. ❑ PLMR. MECH. '❑ M.H. D POOL OOTHER
S/ ...%Y-r
. L.f
9
POGPM
✓1
atcrted
Man/low Liam/Mm. (o.r.wlww
II I
Om. Owl
I�ne..._n
IFl.dr. Too Na0 bare
NWwe T.O
N.. R,aw,.00
wD .paaa 0a.1..1 D
Ptak O Prim. o
I hereby Artily Mat I Nare rod and ssamlr ed TM .pplaelion and Nava reed the •NOTICE• prod... Included an
evere. ate, and know rho eaea to be tree and arm., All provisions of laws and ordlreew.. governing IhO type of
+ore *a.ocnop14d 4.14 *ran ap.c«le! Lore. or nat. TM granting al a penal caw not astern. to give at
moray 10v.eiaeer waned tM pa.ielgn el am Alter Ilea or local law r.gul.ting CornNeallarl w the performance
of mnatrntkn. SEE REV S SIDE FOR AEON ED INSPECTIONS
SIONATUr1E aF , ji1G APPLICAT
OW«EROR AGES'?_ DATE
SPECIAL APPROVALS SPE CONDITIONS: (SEE EV ERSE BIDE FOR NOTI J
E.. No. FIEMil ry 9aTE �'f�• f ICI �.�f (I 2 )
FEES COLLECTED
P ure.,
9.50
W A
dm. abadNl /6r co
TOTAL S/o
PERMIT NUMB 9"f� j
f 1
ua• •1O ..
O1-G9-Iry
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W FINAL INSPECTION: / -3/ -S
SET BACKS
DATE
REMARKS: //
CP
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