1984, 01-09 Permit: 84A-172 Mechanical FixturesPLAN NUMBER
APPL MCAT ION /PERMIT PERMIT NU771�7�2-'
❑ MVE.
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
PARCEL NO.
1• E. 14416 Sunnyside
LOT
BLOCK
SUBDIVISION
WORK 11BLD. ElPLMB. ElMECH.
LEGAL DESCRIPTION:
ElPOOL
2.
I
I
Number
OWNER
or Variance
PHONE
PHONE
3 J. F. Goffinet
DESCRIBE WORK
8.
924-3088
Shorelines/ Flood Hazard
Plans Required ❑
MAILING ADDRESS
Insert
ZIP
Actual Set Backs in Feet to:
E. 14416 Sunnyside Veradale VIA
99037
Nath South East West
GAS
CONTRACTOR
ELECTRIC
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential❑
Valle Fireplace
4.
1 84
1
922-2780
1
1Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
E. 16610 Sprague Ave.
Veradale WA
9903
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5 Contr. License .A.LLIJT-177CG
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck Uncv. Deck
Fin. Basement
Unf in. Basement
6.
I yl't ❑ NEW ❑ ALT. ❑ AWN.
❑ RPL.
❑ MVE.
Plan Check
SEPA
7. OF
El OTHER
MFG.Home
WORK 11BLD. ElPLMB. ElMECH.
ElM.H.
ElPOOL
Certif I. of Exempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESCRIBE WORK
8.
Shorelines/ Flood Hazard
Plans Required ❑
Installation of Convector I
Insert
Yes Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9I UTILITIES I PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
I hereby certify that I have read and examined this application and have read the "NOTICE" providions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REOUIRE PECTIONS
SIGNATURE OF APPLICATION A/#
OWNER OR AGENT -� DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL
�0'
$ '
WHEN MACHINE VALIDATED IN THIS SPACE
THIS BECOMES A PERMIT.
4�j,
DATE
1
DATE ISSID r PERMIT NO.
TOTAL
O
C
C
U
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