1984, 01-17 Permit: 84A-491 ConvectorPLAN NUMBER
APPLIICAT+OR/PERMIT
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
1. 5911 E. 19th Ave.
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. Richard Hankins
MAILING ADDRESS
5911 E. 19th
PHONE
534-3499
PHONE
LEGAL DESCRIPTION:
Spokane,, WA
ZIP
99206
Actual Set Backs in Feet to:
North ISouth
East I West
CONTRACTOR
4 Valley Fireplace
ADDRESS
E. 16610 Sprague
LICENSE EXPIRES
1/1/84
PHONE
922-2780
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
Ave. Veradale, WA
ZIP
99037
Type Const.
Occupancy
Sprinklered
❑Yes No Reg 'd.
5.
DESIGNER
Contr. License IALLEF-177CG
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage ` Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE %NW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑ 6l D. ❑ PLMB..I MECH. ❑ M.H. ❑ POOL
WORK
DESCRIBE MAK
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required YesE No
Received Yes❑ Non
Number
8. Installation of Convector I Supreme Insert.
Shorelines/Flood Hazard
YesC Not Applic.
Plans Required C
Received ❑
VALUATION
9.
SOURCE
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC E
PRIVATE C
SEWAGE
SEPTIC ❑
SEWER ❑
Ownership
Public 0 Private 0
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions 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 REQUIRED INSP TIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION
1l1Ci ' DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PcptiltT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE $SSiUED
PERMIT NOt 9. 1 z * 2 0. 0 0 ii3fm.