1986, 09-25 Permit: 00013289 Wood StoveSIGNATURE OF
APPLICATION
OWNER OR AGENT _ DATE
JOB ADDRESS
4110 8 HOLLOW CT
SHAFER, LARRY M ETUX
471£03 8 HOLLOW CT
aPDI<ANE 3.'WA 99206
SI-IAFER, LARRY M ETUX
SHAFER, LARRY M ETUX-
471T 8 HOLLOW CT
.:
SPOKANE WA 99206
509-927-8533 LICENSE=
ARCH/ENGINEFR
n ODa E48
CITV: ST: ZIP'
CCL=:
335431004
099900
INS CCTO..
00098700
LOT & E
004CN• 001
FINAL_._
FOREST MEADOW 1ST ADD
ZONE..E-I
SFR
X
DG
S.Z
NSE
ED
WOODSTOVE
4110FC55S HOLLOW CT
PROJECT# •
00147'71
DTE 09/25/86
00013289
MECHANICAL $25,00
FEES: $25.00.10 E..
.
X
DG
ND
COUNTER ..1.Lil
.LANE EXAM.
DATE
MECHANICAL PERMIT
MECHANICAL. TOTAL FEE
APPL: Dry 0 Range 0 Gas Log 0 Gas W/H 0 Solid Fuel 01 Fee
FUEL SOURCE: Electric N Gas N Oil N Coal. N Wood Y Solar N
DISTRIBUTION: Forced Air N Radiant Y Heat Pump N
Processing Fee
09 -2.5* -86
OFFICE COPY
$25.00
10.00
15.00
5'28.15 *25,0.0