1991, 04-09 Permit: 91001672 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
»,..,. NUMBER=
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SITE STREET= { { { :: :. •:....
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PERMIT USE= INSTALL HEATIN.G EQUIPMENT & HEAT PUMP
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- OWNER= ,�.E TOM
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12 F 17TH AVE
ADDRESS= SPOKANE WA 99206
4975
, BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA' . REAR= NA
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CONTRACTOR=
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DESCRIPTION STREET= 5103 E TRENT AVE
4 ADDRESS= SPOKANE WA 99212
QUANTITY
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7 PAYMENT DATE ' RECEIPT4 PAYMENT AMOUNT
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i PERXET, TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWTW;
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SPECIAL CONDITION CHECKLIST
Project
Address; �_ Project
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs..
_____________________ -__ Special Insp,Final Report
----- Hydrant ( )
_.___-___—_--_________ Lock Box -----.__�_.__—_-- _________
Engineer's--------- — — RID/CRP _ —______________ — Easements — — —
_._.______._—__—__ -_ Road Plans/Improvements_ _ __ ________
----------- Bonds
Planning Bonds.
Utilities___.___ Double Plumbing
ULID
Other._ —_ -- — —
THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY
•
Date received for C/O processing: Plans pulled for final processing:
Temporary C/O issued:___—____________ e —___.. Certificate of Occupancy issued:______._._________._.__._____.__.____._.__ _____________
Office file review by: --------___._---------------- Date: .
Filed Insp finaled by: ___ Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: __._.________.___._—_.__._.___ .___._ _ Date:_ _______
Pfans returned: -.-__._-- Received by:. _-- --__.-__---_-__.__— -------- ----___-- . ..___.___ ____._.._-
No response from owner/contractor-plans destroyed:_ ____-. _