1981, 10-27 Permit: 81B-1188 Wood StovePLAN 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
1.
2.
3
JOB ADDRESS
N. 4622 Lucille
LEGP,L DE.CRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
Gale Brown (work)
PHONE
928-2000
PARCEL NUMBER/S
ADDRESS
N. 4622 Lucille
ZI P
Actual Set Backs in Feet
North (South East 'West
CONTRACTOR
Valley Fireplace Inc,
PHONE
922.2780
Size of Parcel Zone Classification
ADDRESS
E. 16610 Sprague Ave.
ZIP
99037
Type Const.
Occupancy Sprinklered
Dyes DNo 0 Req'd.
DESIGNER
5. ADDRESS
Contractor Specialty
So. VA LL EF 62b 00
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf In. Basement
TYPE
7. OF
WORK
D NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 OTHER
D BLD. 0 PLMB. D MECH. 0 M.H. 0 POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK Install
8.' RRr Vent intn fir pinne
VALUATIONSOURCEGAS ({I ELECTRIC
OF
9. UTILITIES
"Blaze Princess" Wood stove,
Enum. Dist. 'Location (Area)
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
1 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 INSPECTIONS
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
e
ng Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
PI jibing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
8113 - I\g#3
04* *17.00
*17.00 IT
*17.008
A *000 g
11878
10-27-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
arihvi t 4 i ga
'O;;.2l .8�1.
DATE ISSUED PERMIT NO. TOTAL -
1,17.0 0 2.g
OTAL-
,r17.002.2F