1981, 07-22 Permit 81A-6958 InspectADDESS
MSPECTIcN RECORD
LAN NUMBER 1
2
3.
JOB ADOR
DESIGNER
1i 5. ADDRESS
6.
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811.IEF PERSON / SPOKANE, WASHINGTON 99260 / 16091069"3e76
APPLICANT: COMPLETE NUMBERED SPACES — PRESS S`EAUCR DESCRIPTION COPIES
ATTACHED
CHANGE OF U5
-PARCEL NUMBER/9 �' L� r — 9117
Ez/ NYA. OF t31N Yq- or NA 1
MM
oliK Flo r t
TYPE 0 A1.T. 0 AWN. 0 RPL. 0 AWE. OTHER
T. WORK LQ. ❑ Pone. ❑ MECH. 0 M.H. ❑ POOL
oERMiaall
re` 111110 ��
ATER Nail
8. t uhat I Es� Pm "NUI IUE" Pruvisiuns included
I Thereby certify that I have read and 10 be
true
this application coand have Inau ern dos
side end know the same to be true and correct. All provisions I laws and ul dinances governing
Pied herein or nut. The granting of a nerin'1 does not presume
type al wed will 1W complied or with whether spoil other state or loyal law regulating construction or the
po fot authority 0n violets or cancelE the provisionsSDFOR any / /
parformarlca of construction. SEE REVERSE SIDE REQUIRED INSPECTIONS iG
41, Jr
upper loom
ored
DV. I0No%I❑ ReAra.
DATE OF APPL a GAT
APPROVALS
NAME DATE
F i R +fie
C 'in new
SIGNATURE OF APPLIC
SPECIAL Cp19ITIONSI
G..NH I,IG• eet,4 . CO —
CERTIFICATE
PI EXEMPTIONNllon IANRI
70M) 7/t /
FEES COLLECTED
Single $
Building ={--F�
Plumbing
M»h.
Men Check
BIPA
Mobile Home
Other (Specify!
TOTAL S
ocGSy.
07 —1 3-64
M 6479.-4S*.