1980, 08-05 Permit: 80-8152 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 I(%iAKE 4 COPIES
JOB ADDRESS
1. South 1204 Marigold LEGAL DESCRIPTION -SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
2.
John LaBelle
P��E 0467
3
ADDRESS
ZIP
Required Set Backs in Feet
South 1204 Mariaold
99037
North south East west
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
Western Thermal Systems
483-1017
4. ADDRESSP
Type Const.
Occupancy
Sprinklered
North 2315 Division
9207
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
--
Split Entry
Split Level
Rancher
6. TO
TYPE El NEW E) ALT. 1:1AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
%, OF 11 OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd
11BLD. ❑ PLMB. R MECH: ❑ M.H. ❑ POOL
WORK
of EXEMPTION
DESCRIBE WORK
8. Install Alaska Kodiak fireplace insert FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9, utilities
Single $
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 Building
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 ofconstruction. - Plumbing
8/4/80
DATE SIGNATURE Mech. `d6
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE OFFICIAL
Plan Check
SEPA
Mobile Home
Other (Specify) � ,,�,
TOTAL $�
DATE
M1PERMIT NUMBER
86 8is'z
:.
'7
1 5. 1
c 647?.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES,A PERMIT.
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