1980, 10-09 Permit: 80B-1709 FireplacePLAN NUMBER APPLICATION/ PERMIT
PERMIT�N BER���
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE 10f8/$0
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
2012 N. Sipple
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
PARCEL NUMBER/S
2.
I
ISUBDIVISION
OWNER
PH NE
9 4-9395
I
Robin Brown
3.
ADDRESS
ZIP
Required Set Backs in Feet
2012 N. Sipple
North South East West
' ,, C,
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
Valley Fireplace, Inc.
922-2980
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
E. 16610 Sprague Ave.
99037
❑Yes ❑No ❑ Req'd.
DESIGNER veradale, 7M
PHONE
Valuation
Building Area in Sq. Ft.
5.
–"
ADDRESS No. VA LL EF 626 OMN
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE NEW ALT. 11 AD -N. 1:1 RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF ® OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
E)BLD. ElPLMB. ElMECH: ❑ M.H. El POOL
WORK
of EXEMPTION
DESCRIBE WORK Install "Blaze princess" fireplace insert. FEESCOLLECTED
8.
VALUATION Source GAS ELECTRIC WATER SEWER
of e
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 to I law regulat g c truction or th
Plumbing
performance of construction.
DATE l! SIGNATURE Mech.
_ZPF
-NO-11111
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
THIS $S A PERMIT.
SEPA Checklist :��Y76--k—�—
IlBECOMI
I t` J' r1 ,5
i 7 1 ci 7. 0 { 2
DATE OFF A;L