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1981, 11-19 Permit: 81B-1995 FireplacePLAN 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 3 COPIES JOB ADDRESS LOT 2. N 3223 Williams Rd. BLOCK SUBDIVISION LEGAL DESCRIPTION - SEE ATTACHED 3 OWNER Hrs. Ferguson PHONE 922-1215 PARCEL NUMBER/S ADDRESS Spokane, WA ZIP Actual Set Backs in Feet North 'South East 'West CONTRACTOR 4. ADDRESS Valley Fireplace Inc. E. 16610 Sprague Ave. Veradale. WA PHONE 922-2780 Size of Parcel Zone Classification ZIP 99037 Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. DESIGNER 5 ADDRESS Contractor Specialty No. VA LL SF 626 01/IN PHONE Valuation Building Area in Sq. Ft. ZIP Main Floor Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Area of Decks Finished Basement Unfin. Basement lYJ NEW ❑ BLD. ❑ ALT. ❑ PLMB. ❑ AD'N. MECH. ❑ RPL. ❑ M.H. ❑ MVE. O POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERT' FICATE of EXEMPTION Req'd. Recd. Not Req'd. DESCRIBE WORK Install PreWay Zero Clearance fireplace 8. com ete w/ himney an hearth. VALUATIONSOURCE GAS ELECTRIC OF 9. UTILITIES WATER SEWER Enum. Dist. Location (Area) Ownership Public ❑ Private ❑ 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 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 local law regulating construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION DATE OF APPLICATION --11 SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Building Technician SIGNATURE OF APPLICANT SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building flmbing Mech. 6C) Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 11,00 PERMIT NUMBER l © — 1 ct Gl5 • 04* *17,00 * 17.00 to * 17.006 A *000 199.32 1.1-19-81 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 19,.` 81 1 9 9.55 *1 7, p p .� . - DATE ISSUED PERMIT NO. TOTAL