1981, 12-17 Permit: 81B-2820 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
0) SPOKANE COUNTY — BUILDING CODES DEPARTMENT - �` e:7° 2°
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. 15209 - 1st
LEGt r` DL$CRIPTION — SEE ATTACHED 0'4 * * 1 7, 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * i 7 U 0 !i
2 OWNER PHONE * 1 / C C
3. Andy Hultman 926-3326 A * G n
ADDRESS ZIP Actual Set Backs in Feet
15209 - 1st North 'SouthEast (West 2 8 t 9-
CONTRACTOR PHONE Size of Parcel Zone Classification 1 2 1 7—E 1
Valley Fireplace Inc. 928-5293
4' ADDRESS ZIP Type Const. Occupancy Sprinklered 4 / 9,
E. 16610 Sprague Ave. 99037 Dyes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5 Contractor Specialty
ADDRESS No. VA LL EF 626 OPrN 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 0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF 0 OTHER
WORK 0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Install "Blaze PrinceAs" Fireplace Enum.Dist. ILocation (Area) T FEES COLLECTED
8. Furnace into masonry fireplace wile hearth extension. 1
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private ❑ 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 local law regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION_/ SIGNATURE OF APPLICANT,, ! �Iff^f�; Mech. _ / /
SPECIAL APPROVALS SPECIAL CONDITIONS: , /
NAME DATE Plan Check
Env. Health
SEPA >-
a.
Planning 0U
—
Mobile Home "-'
Fire Marshall
w
Co. Engineer Other (Specify)
Utilities /
TOTAL $ !
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buil g Technician PERMIT IS NONTRANSFERABLE 2 8 x 0 Z' *1 T O 0 d
-� �5.-� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL