1991, 10-18 Permit 91006964 Safety Inspection VOIDSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 13030ROADWAY AVENUE
SPOKAwE'WASH]NGTONgg260
(509)456-3675
1 ceNQthatl haveexaminedth is 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 avmn,/zoo oAno County to proceed wAh Vocessing. In addition, / have uu and understand the /wapsuTmw nsou/nEwsmra/moncs
provisions included herein and agreeto complywith same.All provisions of lawsand ordinances governing thistype ofwork will becomplied with whether specified
herein ornot. 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 �vnmmcuon�
' ' - '
SIGNATURE OF «�~J APPLICATION
OWNER ORAGENT ,/m���~*' ,/�� L~�,^�p�«~�—~ DATE �~^
PROJECT NUMBER= 0006964 ISSUED PERMIT
DATE= i008/9i PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE %TREET= 9418 E BRGADWAY AVE PARCEL@= i7543-0401
ADDRE%%= %POKANE WA 99206
PERMIT U%E= SAFETY INSPECTION OF PROPERTY
PLATO= 001835 PLAT N M = OPP.T i-354
BLOCK= LOT= ZG E= UR-3.5 DI%T*= E
AREA--:; F/A= F WIDTH= DEPTH= R/W=
.0 OF BLDG%= 2 0 DWELLING%= i WATER DI%T =
O N R= GL%ON GEORGE & GINNY
%TREET= 908 E BROADWAY AVE
ADDRE%%= %POKANE WA 99206
CONTACT NAME= GEORGE 3L%ON
BUILDING SETBACKS: FRONT= NA LEFT= NA
PHONE= 509 928 4405
PHONE NUMBER=
RIGHT= NA REAR= NA
******************************* BUILDING PERMIT ****************************
CONTRACTOR= OWNER
NEW=
REMODEL=
PHONE:---:
ADDITION= CHANGE OF USE= X
DWELL UNIT%= i OCCUP. LD= BLDG HGT=
BLDG W X D = X %Q FT= %PRINKLER= N
REQ PARKING= *HANDICAP::--- CRITICAL MAT= N
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
%TATE SURCHARGE Y 4.50
CHANGE OF USE/SAFETY IN%P Y 50.00
%TORIE%=
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
10/18/91, 7765 54.5O
------------
TOTAL DUE:::: Go TOTAL PAID= 54.58
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 54.51) 54.5O .00
------------- ------- ----- — -----
54.5O 54.50 .00
PROCESSED BY: JOHN LAR%ON
PRINTED BY: JOHN LAR%GN
******************************** THANK YOU *********************************