1991, 09-05 Permit: 91005559 Insert, PipingSPOKANE C I DEPARTMENT OF BUILDINGS
11W. 1303 BROADWAY AVENUE
SPOKANE, 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/application and 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 OF
OWNER OR AGENT DATE APPLICATION 7) Sig/
PROJECT NUMBER= 91005559 ISSUED PERMIT DATE= 09/05/91 PAGE= Oi
***************3•***********•* PERMIT INFORMATION **** **if**3f ***iE***+E* *****
SITE STREET= 11510 E 4TH AVE PARCELO= 21541--1905
ADDRESS= ,SPOKANE WA 99206
PERMIT USE= GAS INSERT & PIPING
PLATO= 001839 PLAT NAME= OPP.TR. 1-354
BLOCK= 592 LOT= ZONE= AGSUB DI,STO= F
AREA= 00000000 i'=/A= F WIDTH== DEPTH==
OF BLDGS= 1 v DWELLINGS= i WATER DIST =::
R/W= 40
OWNER= MELVIN MICHAEL & THERESA PHONE= 509 924 4348
STREET== 11 510 (:: 4TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= MICHAEL. OR THERESA MELVIN PHONE NUMBER= 509 924 4348
BUILDING SETBACKS: FRONT== NA LEFT= NA RIGHT== NA REAR== NA
******************************* MECHANICAL PERMIT **************3f*35.31•**3t•*3i•3t•**
CONTRACTOR= OWNER PHONE=
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE Y 25.00
GAS PIPING i 1.00
GAS LOG 1 10.00
******************************* PAYMENT SUMMARY *********3i•******************
PAYMENT DATE RECEIPT; PAYMENT AMOUNT
09/05/91 6303 36.00
TOTAL DUE= .00 TOTAL PAID= 36.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
MECHANICAL PRMT 36.00 36.00 .00
36.00 36.00 .00
PROCESSED BY: JULIE SHATTO
PRINTED BY: JULIE SHATTO
*3f3f***************************** THANK YOU ********************%***..*..********