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1982, 11-03 Permit: 82B-0506 Fireplace InsertPLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES JOB ADDRESS S. 2825 Best LEGAL DESCRIPTION — SEE ATTACHED LOT 2. BLOCK SUBDIVISION PARCEL NUMBER/S 3. OWNER ADDRESS Jim Lindblad S. 2825 Beat PHONE 928 1493 ZIP Actual Set Backs in Feet North 'South East 'West CONTRACTOR 4' ADDRESS Valley Fireplace Inc. PHONE 922 2780 Size of Parcel 1 Zone Classification DESIGNER 5. ADDRESS E. 16610 Sprague Ave. Veradale, RA 99067 Contractor License No. VA LL EF S26 OMN ZIP Type Const. Occupancy Sprinklered ❑Yes ❑Na ❑ Req'd. PHONE Valuation 'Building Area in Sq. Ft. ZIP Main Floor Upper Floors I Garage Area Storage CHANGE OF USE FROM 6. TYPE ]t OF WORK TO Area of Decks Finished Basement Unfin. Basement E NEW 0 ALT. 0 AAD'N. ❑ RPL. 0 MVE. ❑ BLD. 0 PLMB. MECH. 0 M.H. 0 POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK Install "Lopi" Large Extended (LX) Fire {place Insert into masonry fireplace. VALUATION SOURCE OF 9. UTILITIES GAS ELECTRIC WATER Enum. Dist. Location (Area) SEWER Ownership Public ❑Private ❑ USE CODE 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 authority 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 INSPECTIOIy1S DATE OF APPLICATION )//-- SIGNATURE OF APPLICANT SPECIAL CONDITIONS: SPECIAL APPROVALS NAME DATE Env, Health Planning Fire Marshall Co. Engineer !Jti!It ies Plans Examiner SEPA Checklist PERMIT IS NONTRANSFERABLE 1 FEES COLLECTED Single $ Building Plumbing Mech. �-� Plan Check SEPA Mobile Home Other (Specify) TOTAL $ PERMIT NUMBER 0-2-h-o5o( 04* *20.00 *20.006 A *000 5058 11-03-82 E 6.479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 11-03-8'2 50.65 *20.00a� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL