1982, 06-21 Pemrit: 82A-5136 FireplacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS 1-c;,RD TO MAKE 3 COPIES
JOB ADDRESS
1.
S. 3715 ervy Ct.
LEGAL DESCRIPTION — SEE ATTACHED
2.
3.
4.
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
Gary rus.m.an
ADDRESS
S. 3715 idoray C -`.;-
CONTRACTOR
Valley. Fireplace,
PHONE
928-3536
inc.
ZIP
992C)F,
PHONE
922-2780
Actual Set Backs in Feet
North (South
East 'West
Size of Parcel 1 Zone Classification
ADDRESS
:S. 16610 Sprap:ue
5.
DESIGNER
Contraotor License
e. Veradale ',`,A
LL =1E:.
ZIP
90037
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ 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 Blaze Pr"Lnoess (1':17.'?imun
8. Fire;;la e) P� `J-282 u:;:inc ex=Ln-h m
n,g hinn
VALUATION SOURCE GAS ELECTRIC WATEPt
9. UTILITIES
OF
1 C1earaalcc
Enum. Dist,
Location (Area)
SEWER
Ownership
Public 0 Private 0
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 tru@ 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
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bui T nician
•
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single
Building
Plumbing
44
Mech.
-��..
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
04* *2000
*20.006
A *000 S
51358
06-21-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0-I2'1 8 2
513,65 *20.0'02 -