1981, 03-11 Permit: 81A-2294 Wood Stove PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER�
�
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
} NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
V APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 0 * * 1 7.0 0
Job ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
1. I. 15803 - 11th * 1 i. 0 0 N
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. `�
* 17.00)
OWNER PHONE P; * 0:Ci
George Hauserman 924-6209
3.
ADDRESS ZIP Actual Set Backs in Feet 2 2 9.3=c
15803 - 11th North 'South East IWest 0 4 1 1 -8 1
CONTRACTOR
PHONE Size of Parcel Zone Classification
Valley Fireplace, Inc. 922-2780 U 9
4' ADDRESS ZIP Type Const. I Occupancy Sprinklered
L. 16610 Sprague Ave.- 99037 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
Veradale, WA —
5' ADDRESS Contractor Specialty ZIP Main Floor Upper Floors Garage Area Storage
No. VA T,T, .r 1' F26 OlViN
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, OFPi OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. 0 PLMB. El MECH. 0 M.H. ❑ POOL of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area) ' FEES COLLECTED
8
Install "Blaze King" wood stove and
ttref'�bricai d r
hirnna�. USE CODE
VALUATION SOl7RCE I GAS ELECT IC WATER SEWER Ownership
OF
9. UTILITIES Public 0 Private 0 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 g
performance of construction.SE//E REVERSE SIDE FOR REQUIRED INSPECTIONSe
DATE OF APPLICATION /` /( SIGNATURE OF APPLICANT/ 746" i8 /PIumbin
Mech. / 7
SPECIAL APPROVALS PECIAL CONDITIONS: Plan Check
NAME DATE
Env. Health ready for inspection.
SEPA n
C_...)
Planning - u
Mobile Home J_ .
Fire Marshall
Other(Specify)
Co.Engineer
Utilities TOTAL $ /7'
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist
r •PERMIT IS NONTRANSFERABLE 0 51.—li���'°,$ 1.' 2 2 9.4 z *1 7.0 0 a F -
Buildin echr ni i n
iPERMIT NO. TOTAL
wDATE ISSUED"'� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE