1984, 04-27 Permit: 00000079 Fireplace InsertSIGNATURE OF APPLICATION
OWNER OR AGENT DATE
.I1Yf",-ESS:S MICA PARK
AR
D19 KSON,
DENNIS
$20.00
AD r,jN S MICA PARK
AR
`9POKANE
ST: WA
ZIP!992060000
^Y9bVbON,
DENNIS,
CONTRACTOR:
ADDRESS:
CITY:
ST:
ZIP:
PN:
LICENSE*:
ARCNJENGINEER:
ADDRESS:
CITY:
ST:
ZIP:
fVV 1724
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INSPECTOR:
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FINAL
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ZONE*:
I ZONE
FRIo A
1 Sp b 0
S 0,0 w
Rgso 0
MOD
PLANS EXAM:
` VEACE
INSERT
5:S MICA PARK
J(]B1AV2E5
DR
MECHANICAL
Processing
Appl: Dry
SEV 40049
DATE: {J4/2//84
PROT6000077
Mechanical Fee
$20.00
PEES: $20 / 0 0
U
PAID BY:
CA
CR
CG
NC
COUNTER
PLANS EXAM:
pgTE:/2 __/8
M E C H A N I C A L
fee Y Misc fee desc
0 Range 0 Gaslog 0 Gas w/h
V
P E R M I T
TOTAL FEES $20100
Amount $0100 fee; $10.00
0 Solid Fuel 01 fee; $10.00
04`='27'-84 384.0 *20.00YU
y
0-
0
U
w
U
U.
LL
0