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1993, 09-21 Permit App: 93008607 Pool• Spokane County 7.3"' DEPARTMENT OF BUILDINGS West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET, PARCEL NUMBER: STREET ADDRESS: CITY/STATE/ZIP: SUBDIVISION: BLOCK: LOT AREA: # OF BUILDINGS: 3610 S 0.69/2..)22 0.1f9. 9'9 Z Bb M LOT: F/A: ZONE: DISTRICT: WIDTH: DEPTH: R/W: # OF DWELLINGS: WATER DISTRICT: OWNER: '�` S O PHONE: Z? % --922- O/c‘, .5-1 0 $ MAILING ADDRESS: CITY/STATE/ZIP: ...ced6t//9-'- CONTACT: n SETBACKS: - FRONT:36 LEFT: 10/ PERMIT USE: /41 46..,-e.r PHONE: 5-0- RIGHT: a, REAR: 56' 12?SOoo^11e ****************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: ,69-ef-c0../)..7'•-= .'t1 CONTRACTOR: Ar5e !'it/QX �iv . PHONE: sal -2$67.-- 6 J V c - MAILING ADDRESS: I— /3S .)--c( 4W 4%i'Jf2(( ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: NEW: X REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: JOB STREET ADDRESS: MECHANICAL PERMIT,APPLICATION FORM Information Worksheet 3 s'� o s oee4.e CITY/STATE/ZIP: )/4- .. ' 5 ZO PARCEL NUMBER: OWNER: e,ualP PHONE NUMBER: 92 2/8-4 MAILING A DRESS: 3.5N/ 0 S e9. ffie c,.4- 9' .oL (Street) (City/State) (Zip) CONTRACTOR: 4.64 LICENSE NUMBER: O37 L-1=-?VV/GY° PHONE NUMBER: qZf-6s-es- MAILING ADDRESS: (35;2 ( s_404074. - (Street) _ 9 (Street) MECHANICAL WORK DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTQYE11:4S:ERT GAS WATER HEATER GAS EQUIPMEN ' <100,000 BTU {INCLUDES GAS EQUIPMENT +100,000 BTU K) GAS: PIPING: :.:: BOILER/REFRIG .1 1-100M BTU BOILER/REFRIG 10100M B BOILER/REFRIG 501-1,000M BTU BOILER/RERRIG x,0001 1 750M BTU, BOILER/REFRIG +1,750M BTU HEAT:PUMP;& AIR CONDITIONER 0 S TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEATPUMP & AIR CONDITIONER. 5 30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS ;HEAT PUMP & AIR. CONDITIONER;}50 TONS VENTILATING FANS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER RANGE GAS LOG MISCEL.LANEO S (NOT.COVERED LSEWHEF UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS APPLIANCE 5400;00:0 BTU :: USED <466,66 AIR BTU AIR HANDLER <10,000 CFM AIR::f�ANOLER :10000>CPMENGEM NOTE: MINIMUM PER t, FE IS $35.00 SIGNATUR ( it/ P4- - (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x15.00 = L. ( /S.4a 1 x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x25.00 = x 35.00 = x60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x50.00 = x100.00 = x50.00 =, x100.00 = x 12.00 = x 15.00 = l o� SUBTOTAL $ /,66 PLUS: PROCESSING FEE + $ ZSi0e- EQUALS: TOTAL PERMIT FEE DUE / . Bch = $ pokane County Division of Buildings Woo 14n4 Prnariwav Avant is SnnkanP. WA 99260 (509) 456-3675 j- DETACH TO DISPLAY CERTIFICATE -� DEPARTMENT OF LABOR AND INDUSTRIES THIS CERTIFIES THAT THE PERSON NAMED HEREON IS REGISTERED AS PROVIDED BY LAW AS A REGISTRATION NUMBER . EXPIRATION DATE CCO1 fOOL,Z*241tp 01!29/94 t.FFCCTIVE DATE 02/17!70' WA 992140927 STATE OF WASHINGTON F625-052-000 (3-92) L DFT.ACH TO DISPLAY CERTIFICATE _? Today's date: Site address: ['m proposing to build: ORIGINAL SITE PLAN • Parcel number or legal description: irf