1984, 10-19 Permit App: 00002942 Wood Stove MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name Last) (First) (M) Department Use Only
C-
N-.;a:0(1,11,- (I Project No.
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2 /Project Address(Not Mailing Add 7ss) Space Zip
AAi rth 4._..Ic--I 1,.,16,!(-4,/ /!
3 City/Community State Subdiv' 'on/Plat Name
0 a-411-e-, 207/1 Lyle.?
4 Assessor Parcel No. Lot ! Block
16 Contractor Firm Name Street Address
17 Zip City State Phone
( )
18 Contact Person I License No. Phone if different than above
8 Owner/Agent(if different than#1 above) Business Address
9 Zip City State Phone
( )
15 Describe Work:
New ❑ Addition/Alteration ❑ Replace/Repair ❑
10 Applicant Name Street Address
11 Zip City State Phone
( )
8 VENT: Fan(s): Evap Cooler(s): Hood(s): Duct(s)1: Miscellaneous:
i T
10 APPLIANCE: Wood Stove/
Dryer(s): Range(s): Gas Log(s): Solid Fuel: Gas Water Heater(s):
Z 11 UNIT HEATER(S): Wall Mount: Y N Floor: Y N Suspended: Y N
W
a 12 AIR HANDLING: 10,000 CFM or less: More than 10,000 CFM:
5
W 13 REFRIG SYSTEM BTU: 1-100M: 100-500M: 500-1000M:
U-
0
14 1000-1750M: Other: Pressure Vessel(cu.ft.):
a
>-
I-
O 15 COMPRESSOR/HP: Lessthan3: 3-15: 15-30: 30-50: 50+:
I
W 16 GAS PIPING SYSTEM:Number of outlets:
co
17 HEATING SYSTEM:1-100,000 BTU: 100,001+ BTU:
z
18 TYPE FUEL SOURCE: Electric ❑ ; Gas ❑ ; Oil ❑ ; Coal ❑ ; Wood 8 ; Solar ❑
19 TYPE DISTRIBUTION: Forced Air ❑ ; Radiant ❑ ; Heat Pump❑
41.
1* Number of separate zones for any heating, A/C or air handling system.
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any state of local laws regulating construction or the performance of
construction,
SIGNATURE OF APPLICATION
OWNER OR DATE
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Spokane County
' ;‘'-4
i, Irl
III :4, department of building; & safety
g01.Ip}541,OLVhcti ��'' JAMES L. MANSON, DIRECTOR
TO Environmmental Health Division
FROM : Department of Building and Safety
DATE : June 7 , 1984
RE On Site Sewage Disposal System
REF : Road Name Vincent Road
Parcel Number 36654-0229
Owner ' s Name Lowell Skeen
1 . This is to advise that we have reviewed the subject property and
it meets the minimum requirements of the Spokane County Zoning
Ordinance for the use of a single family residence .
Planning Department
2 . An initial review of the subject property has been conducted by
the Spokane County Engineer ' s Office and the following items are
noted . An in depth final review of the property will be made at the
time the building permit is applied for .
SPECIAL REQUIREMENTS :
Maintained County Road Frontage
Approach Permit Required
Flood Zone
Variance Requirements
Other : ' _ � 7 � � ; --/.., /�moL
% `
Engineer ' s Office %111.4e ( /7
3 . The Spokane County Department of Building and Safety has no
objection to the Environmental Health Division of the Spokane County
Health District releasing a permit to install an on -site sewage
disposal system prior to a building permit being obtaired . The
property owner/ representative has been advised that at such time
that a structure is to be placed/constructed on the property , a
building permit will be required .
Additionally , other department approvals may be required prior to
the issuance of the building permit .
Building and Safety Department . i4"- U
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NORTH 811 JEFFERSON • SPOKANE,WASHINGTON 99260•0050 • TELEPHONE(509)456-3675