1981, 09-15 Permit: 81A-9341 Insert PLAN NUMBER PERMIT NUMBER
APPLICATION/PERMIT � St/1c -�
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
(1 /
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL Di SCRIPTION — SEE ATTACHED
1. E. 13222 Vallevvay
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 0 4 * * 1 7.O O
2.
OWNER PHONE * 1 7,0 0
3. Bill Deloney 928-5544
ADDRESS ZIP Actual Set Backs in Feet * 1 7,0 0 x v
13222 Valleyway Spokane, WA 99216 North 'SouthEast 'West A * 0 0 0 8
CONTRACTOR PHONE Size of Parcel Zone Classification
Valley Fireplace. Inc. 922-2780 9 3 4.0 2
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
±. 16610 Sprague Ave. Veradale, 'WA99037 ❑Yes ❑No ❑ Req'd. 0 9— 1 5—81
DESIGNER Contractor Specialty PHONE Valuation Building Area in Sq. Ft. z 6 4 7 9,
5. ADDRESS NO• VA LL 626 U=� ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF D OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) ' FEES COLLECTED
8. Install free standing fireplace w/pre-fab chimney. I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF Public D Private ❑
9. UTILITIESSingle $
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 of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
...7 / /
7
DA
(,' TE OF APPLICATION SIGNATURE OF APPLICANT p�Grl Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: /
NAME DATE Plan Check
Env. Health Ready now for inspection.
SEPA a
Planning O
_ U
Mobile Home w
Fire Marshall —I
Li
Co. Engineer Other (Specify)
Utilities ?
TOTAL $ /
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
� echnhI
t� PERMIT IS NONTRANSFERABLE �9�-+i' �8'1 9�3 41 z *17..0 °a,�' _
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL