1985, 10-24 Permit App: 00008298 Siding(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPARTMENTAL USE
Zat
Owner's Name
LAST
Koentopp Jack
FIRST MI
Project Address (Street Name & Number)
East 14002 Nixon Spokane, Washington
Zip
Applicant
MECO INC.
Address
P.O. Box 9690
City
Spokane
State
Washington
Zip
99209-9690
Phone
(509 ) 325-1322
Business Phone
Contractor/Agent
Same
Address
City
State
Zip
Phone
Contact
Nancy
License Numper (Required)
ppliea
Business 7369
325-1322
Architect/ Engineer
Address
City
State
Zip
Phone
Contact
Business Phone
Lender
Address
DEPARTMENTAL REVIEW
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent to compile said application is true and correct.
Signature Date
Approved
CpApproval
Hold
Environmental Health Application #
W. 1101 College
Room 200
Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson
Utilities
N. 811 Jefferson
I
Plan Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection Information
Project Representative
Phone
Address
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent to compile said application is true and correct.
Signature Date