1979, 11-05 Permit: 79-7267 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 4 COPIES
JOB ADDRESS
1.
N. 1112 Progress Rd. Veradale, WA.
LEGAL DESCRIPTION — SEE ATTACHED
2.
3
LOT
BLOCK
SUBDIVISION
OWNER
Robert K. Edens
PHONE
928-9165
PARCEL NUMBER/S
ADDRESS
N. 1112 Progress Rd.
ZI P
Required Set Backs in Feet
North (South East (West
4.
5.
CONTRACTOR
Valley Fireplace, Inc.
PHONE
922-2780
Size of Parcel Zone Classification
ADDRESS
DESIGNER
ADDRESS
E. 16610 Sprague Ave. Veradale
ZIP
99037
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
CI POOL OTHER
Fireplace
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Install
VALUATION
9.
"Earth Stove"
Source
of
Utilities
with insulated chimney
GAS
ELECTRIC
as
per
Et at
WATER
SEWER
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
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 jocall liw regulatinco.. uction or the
performance of construction.
DATE /'-- 7ff SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIA
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /
/v1
PERMIT NUMBER
7r— 7,. , 7
DATE 11/1/79
04* *7,00
*7,00
*700(5
E *000
72662
11-05-79
2 6479,
APPPfVFf1 Ff1R ISSIIAN(:F
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11-05'-79
7267, ,*7,00°H