1986, 11-14 Permit: 00014194 Wood StoveSIGN, 1 URE OF
OWNER OR AGENT
JOB ADDRESS
R 1)
OWNER:
LARK / , t'-1t T H `I:2
ADDRESS:
RD
CITY: ST: ZIP: ff
PPLICANT:
LAPP -Y ' SM i TH G19
CONTRACTOR:
LA i . SMftEd ED
ADDRESS:
3. t N e:; A N is N RD
CITY: /� ST: ZIP:
KAiCp� E WA 99216
PH: LICENSE*:
ARCH /ENGINEER:
ADDRESS:
CITY: ST: ZIP:
PARCEL.:
CENSUS TR:
C.D000
INSPECTOR:
PLAT.:
LOT e< BLOCK
FINAL
PLAT NAME:
ZONEa: (ZONE
1
F5B
5-1
5-2
RSB
MOD
COUNTER APP: I1 .� V ^
— \ t rV V
USE OF PERMIT:
JOB ADDRESS:
DATECATIONiw /fib
PROJECT#
SEQ. *:
-1, : .,'' -..3
DATE:
,/y q
)0014i 4
iECI•'1ANiCA1.. '3s;'5 1 00
FEES:
$25,00
PAID BY:
CA
CK
CG
NC
COUNTER APP: I1 .� V ^
— \ t rV V
PLANS EXAM:
DATE:
MECHANICAL PERMIT
C1'IAN1:CAL.. 'TO'TAI... FEE
I i'PI...; I)r 0 Range 0 Gas Log 0 Gas WsI°i 0 Solid it�`ue�1. 01 Fee
t.; :L. SOURCE: L1eL•rric N Gas N O.i1. N Coal, N Wood Y Solar N
.f1:STRT1t1i'T1:ON; Forced Air N Radiant 'Y` Heat Pump N
Processing Fee
11-14-6
OFFICE COPY
$25,00
10,00
15,00
638.42 *25.00