1992, 11-23 Permit: 92010297 Gas PipingSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOINANE, 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/applicationand 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, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OFAPPLICATION
OWNER OR AGENT (Erin Me,_ �^ —PgfY\ DATE
PROJECT NUMBER= 92010297
*******R'*************3t******
/7 -- 7
ISSUED PERMIT DATE= 11/23/92 PAGE= Oi
PERMIT INFORMATION **
3f#***********************
SITE STREET= 1711 N LOCUST RD PARCE_L_O= 45083.9011
ADDRESS= SPOKANE WA 99206
PERMIT USE= GAS PIPING
PLATO= 001853 PLAT NAME= OPPORTUNITY PLAT 4 2
BLOCK= LOT= ZONE= UR -3.5 DIST0=
AREA= F/A= F WIDTH= 138 DEPTH= 300 R/W= 45
OF BLDGS= i a DWELLINGS= 1 WATER DIST =
OWNER= VANBROCKL..IN, GILBERT R
STREET= P 0 BOX 13501
ADDRESS= SPOKANE WA 99213
PHONE= 509 924 7695
CONTACT NAME= GILBERT VAN BROCKLIN PHONE:: NUMBER= 509 924 7695
BUILDING SETBACKS: FRONT= NA LEFT= NA Ii:E.GH'T== Ns REAR== NA
*************3<******3 3 **313 3t3 *3r* MECHANICAL_ PERMIT **3'4*3e4e3E1 *3i* *3 4H**1 1 3e11*****
CONTRACTOR= OWNER PHONE==
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y 25.00
GAS PIPING i 1.00
MINIMUM FEE ADJUSTMENT Y 9.00
******************************* PAYMENT SUMMARY ***************************
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
ii/23/92 529 35.00
TOTAL DUE= .00 TOTAL.. PAID= 35.00
PERMIT TYPE.: FEE AMOUNT AMOUNT PAID AMOUNT OWING
MECHANICAL. PRMT 35.00 35.00 .00
35.00 35.00 .00
PROCESSED BY: BARRY HUSFLOEN
PRINTED BY: BARRY HUSFLOEN
*'******************************* THANK YOU *************•********•************