1995, 09-21 Investigation RequestSPOKANE COUNTY
Division of Buildings
James L. Manson, Director
1026 West Broadway Avenue
Spokane, Washington 99260
(509) 456-3675
INVESTIGATION
REQUEST
Date of complaint
Taken by:
✓ Does this violation appear to be an immediate threat to the life, health, or safety to the
occupant or the public?
COMPLAINT TNFORMAT'IO:
Property ownership and Iocation of alleged violation
Address (or location description):
Property Owner:
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Occupant
COMPLAATN:T DESGRTPTION'
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✓ When did the violation begin, or when was it first observed?
V. Can the violation be observed from a public road or right-of-way?
The identity of the complainant will be protected to the maximum extent of the law. Anonymity, however, cannot be
absolutely guaranteed. In some circumstances under public disclosure regulations or when the complainant's
testimony is required to establish that a violation occurred, a person's identity may be revealed.
DO Mar CIDPIer
Name:.' �.,z•s/_--
Address: City/State/Zip:
Phone #: Signature:
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VIET
DATE RECEIVED: - i' 1 COMPLIANCE COORDINATOR:
RELATED IN//FORMATION (FILE CHECK)): (1U =1 �� < <'+-i
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0 Nondepartmental issue, see "compliance action"
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INSTRUCTION TO FIELD INSPECTOR:
DATE RECEIVED
FROM CODE COMPLIANCE:
INSPECTOR:
OBSERVATIONS/ RECOMMENDATIONS:
ACTION TAKEN:
O Stop work order placed. Explanation:
O Correction notice placed. Explanation:
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AN
......................
DATE RECEIVED
FROM INSPECTOR:
COMPLIANCE ACTION TAKEN:
O Dismissed. Explanation:
O Referred to other agency:
O Resolved. Explanation:
O Compliance file opened. File #:
O Other: