1983, 05-04 Permit 83A-1391 InspectADDRESS
REMARKS
INSPECTION RECORD
PLAN NUMBER
ST STADORE
LOT
oo.T
Al SS
3.
1. AooPans
e. AOOREO
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT DOFIB» ILIDIINGµ SAFETY
NORTH.11 JEFFERSON I SPOKANE,
WA MI APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
PARCEL NO. 4•
[7 �rl► , 6 LEOAL DESCRIPTION:
CWHOElYNEE sM.
Mbar M am. wM1w
bb�Or. V•rwrr•
borrow
E. bw... Eon fun
0 .S E.*.
VALUATE. ErArM112521"
O• W rim •NOTICE' Wa•IFNrr Included On
hereby Certify tat 1 M11 rrad MO rammed MN WWIUOen W IIPoe rod Al and NOT IC Op0Ernl*O INE 1TPE e1
r.nerr Mr. And row Ilmo Arno le be low And correct All
EOM *M0Mer .PEN110O Morn w rat. TAM or IIW r • porn Swe MI Armor r to Or of
, rI rill M MOW
r-
ear/ H vWNe w r,Encr tM prpArane of any ono .Ire o lad WA replotting eamlrlMbn a re
rrWir0nlon. ROE 910E FOR REQUIRED 1NOPECTIO01
SPECIAL CONDITIONS: PIE REVERSE BIDE FOR NOTICE)
TYPE .E NEW 0 ALT. 0 AWN. ❑ RRPL. OWE. O OTHER
T' D OLD. 0 FLMB. D MECH. f�M.H. D POOL
WORN
DE
SIGNATURE OF
OWH910OR AOENT
SPECIAL APPROVA S
Env or.
YE.
NINONIN- EN
MINIM
-.-
I b Jc '
SACTNC
PEEM1T
APPLICATION
DATE
Zor
07. •S0uc
134.0*
03-01-A3
667S
OTw Ober OM'A
Tow E.E. E✓ ow
Onbo.E�•oV
Ib• D.wPT
Rgwd V.0 N•0 'w'M
Rsw.d Yw0 w0
Rw AwWaD
RW.a 0
FEES COLLECTED
TOTAL S r
WHEN MACHINE VALIDATED IN THIS SPACE
u