1991, 11-06 Permit 91007634 ShopSPOKANE 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 anystate or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF
OWNER OR AGENT Y—�� ��+—+"�7 DATE APPLICATION //^C _ q /
NUMBER:::: 91007634 -.,» .... ...
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ADDRESS= SPOKANE WA 99212
PERMIT
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i" Ei tO N E_ -_ 509 928 0685
CONTACT Nell"I(-= HE:RSCHEI._ KING PHONE NUMBER-.509 928 0665
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CON I RAt»: i OR._• OWNER PHONE=
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I E,. Ct IPT ON GROUP TYPE : Q FT VALUATION
,..;ii0:F' "j_1 ,�L�i .,.j _ _.64s:' 00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
NT
RESIDENTIAL VALUATION ,r 106.,00
STATE Silrc iARrE" •Y 4,50
COUNTY SURCHARGE RG ;+ 17.26
A „•. •.
Jl '1!• ){ 1i• P: 9l 9L P: Il 9l P: 7 F: P: )l 9L yt 9S �: de 9t 9t 9r 91: '1L• �Jk It• X 1� 9L ll I-• � � r I I ::. I� ��• I»� i"i I"t �'f � i i it lk * Jt * JL Jl 1L !i 9: N: !i- )L It 9Y at• 9L• •1>::0.• JL' 9L• 'Jl * 7L• •P: 'll• •JL• •1,:
PAYMENT DATE E RECE.I.i E :ii PAYMENT T AMOUNT
I"I.
`I i / 0 6 ,i 91 8433 129.76
TOTALi,lU _ - .00 TOTAL L j.j::r. 129.78
PERMIT TYPE :iE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 129.78
129,78
297r 00
129.7R 129,76 .00
:'.RECCE" SE.%? BY: ✓4ENDEi_., GLOR :A
PRINTED 1. WE NDEi_., G r O t t
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