1991, 07-10 Permit: 91004092 Mechanical Fixtures SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W.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,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 91 [0.092 ISSUED PERMIT DATE= 07/10/91 PAGE= ?r
•}t•*****R••P:**** b:•***•P:'A'R••}(•jk 3{***•}>:)j :f:t:m.f. 1 .1.N r'1.j R PI A E T O N 'p•'R'.R•'p:*!t*'P•*•;4:p:'•R•'R•A•*it••p:*•*P:•P:'R••p:•p:'P:'7!:''A:'K
SITE E. TRE ..T= 10202 F 4TH AVE Y`ARt:,i::.1...O=:: 20541 -1404
ADDRESS= SPOKANE WA 99206
PERMIT USE= GAS FURNACE,CE PIPING, & A/C
PLATO= 001834 PLAT NAME= OP :.TR. 1 -354
BLOCK= 233 LOT= ZONE= AGSUB DIET4=
AREA= 0(,)000000 i:•;'A-: F W 7:T>•T h•i::_ _ I:;i::I�`7•I•'I:::: F.!; -. 40
•„• ill:: l�L..ltCv,'.:::: 1 :ff: 1?t�I1::.I...I....EfJts,:;:::: 'I WATER DIET ....
OWNER== SIMON,.4, FRANK PHONE= 509 926 1669
STREET=E=.T::= i 020,:: E 4TH AVE
ADDRESS= SPOKANE WA Vii 206
CONTACT NAME= RUES L1,iNDE:: PHOPHONENUMBER= 509(i 535 1711
BUILDING
, r
il!.ILDING SETBACK.S : FRONT:::: NA LEFT= NA RIGHT= NA REAR:::: NA
)4:1ti.:M.ie:1<.:ri.*•ii•*•a:h:•ri•***•b:s:ii ii*•a*ie h:3i*k u*k k MECHANICAL PERMIT •:••ii h::u•;G.r:.A..ii•iii•h:*'if..;<..;i•**•ri•h:a•ii••ii**•n:•p:•p:
CONTRACTOR== BANNER FURNACE Nt"3t."..E FUEL I II :I I C PHONE= '.:ii.9 535 1 i 1
STREET=E::T== E' t:i BOX 4346
ADDRESS= SPOKANE WA 99202
ITEM DESCRIPTION QUANTITY FEE: AMOUNT
PROCESSING FEE 25.00
G fA1 S. I-I•T tx I:'t.?t.i 3.P°: 1 4:i t'_i, t) ,(}? i l l,•i i f2.00
GAS PIPING 1 ,00
A:r.R CONDITIONER 0....3 TONS 1 12.00
•r.•*fi•ii••>•;•p:*•,a x•n.•*ri••n:*ik*•ni•n:n•*•}{•:r•R•*•x*•}i•3+:ii N;* PAYMENT SUMMARY }l•;{•-;l'}I•ik•}L 3k 3k P''14•*'}1'Jt'p:'14•A'',t:'A':•p:•R•9E:'R'•R''p:•p:N:'.';
PAYMENT T DATE RECEIPT : PAYMENT AMOUNT
07/10/91 4554 4 50 00
TOTAL isUE.:=: .00 TOTAL PAID= 50.00
PERMIT 'T'YPE FEE:: AMOUNT AMOUNT PAID AMOUNT OWING
MEt..:HANIc::Ai... PRMT 50 .00'' :.00 ..00
50.00 50.00 ,00
PROCESSED BY : :.iUI....I.E:: `'HA i T°
PRINTED BY : ..IHi...1:E:: SHA_....I.O
•R••,l••p:'H••p:•R•}l•11'*•;t•b:'F:*•P:it•'P:P:'p:A:b:P:N:•A:4k•R••P:*it'*'A:3l* THANK 7 f„I,.i 'P:'p:'!k:n:*'A:•1t'•A•}{'11•n 4+:'R•*ih',!'•p.'*14'1k 7t'it•p:•P•'P:'/k...:.p:.p:.p...p•.p:
SPECIAL CONDITION CHECKLIST
Project
Address: ____ ___ _ _ Project# __ Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp,Final Report
—_ — Hydrant( ) -- — — —
Lock Box w_ -------
Engineer's_.__— — RID/CRP
Easements
Road Plans/Improvements — —
Bonds • . ,
Planning _ Bonds:—_ — —__
Utilities Double Plumbing —
— ULID
Other — _ — . . . — —.
**** *******`*************THISSPACEFORCOMMERCIALPLANSTRACKING,CERTIFICATEOFOCCUPANCYONLY******************************
Date received for C/a processing: _ _ _—_ — Plans pulled for final processing:
Temporary C/O issued.._____ ___ Certificate of Occupancy issued:.__.__._____
Office file review by: . Date:..-- .--
Filed Insp finaled by: --- --- . Date:__w__ — --.------- —
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans:-_-- __-_ Date:-------____.__.__._._.___._______ ____
Received by:-- —.- ______.____ _--
Plansreturned: .—______._._.___._----___------___._—_-_____� _____. _ _ __..--------_-.------------_-
No response from owner/contractor-plans destroyed: