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1984, 10-01 Permit: 00002591 Wood Stove
• * IGNATURE OF �—''l APPLICATION/�/2 / JW - ;:15:1 NER OR AGENT / _ter i DATE / C/ /S JOB ADDRESS: SEQ. *: DATE: PROD*: -tQa2T-E 4TH AV 0002702 10/01/84 00002591 OWNER: I_i:ISI-I, BEN Mechanica]. Fee $20 . 00 ADDRESS: 18221 E 4TH AV CITY: ST: ZIP: CREENACRES WA 99016-0000 APPLICANT: LOSH, BEN CONTRACTOR: ADDRESS: CITY: ST: ZIP: PH: LICENSE*: ARCH/ENGINEER: ADDRESS: CITY: ST: ZIP: PARCEL*: CENSUS TR: INSPECTOR: 205520906 0999 PLAT*: LOT&BLOCK FINAL 020552 009 006 PLAT NAME: 202545 ZONE*: ZONE FSB 5-I 5-2 RSB MOD 000 000 000 000 USE OF PERMIT: FEES: PAID BY: CA CK CG NC WOOD STOVE $20 . 00 X JOB ADDRESS: COUNTER . ' / PLANS EXAM: DATE: 18221 E 4TH AV 10✓01/8.0 MECHANICAL P RMIT MECHANICAL WTAL FEES $20 . 00 Processing fee Y Misc fee desc Amt $0 . 00 fee : $10 . 00 App:I : Dry 0 Range 0 Casing 0 Gas:; w/h 0 Solid Fuel 01 fee : $10 . 00 a 0 0 W 0 LL LL 0 = r 10 -01 -'84 73395 * 20. 006