1983, 06-06 Permit: 83A-4847 FireplacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
1131.0
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER-,rj. "011
PHONE923-300
PHONE
LEGAL DSCRIPtION:
MAILING ADDRESS 11610 + 47th.
ZIP
Actual Set Backs in Feet to:
North (South 'East West
4.
5.
CONTRACTOR ;"alley Fireplace
LICEsISIEE EXPIRES
P1 -9T -276Q
ADDRESS . 16610 S -ora ,ue Ave.
DESIGNER 'r or , 17A.
ADDRESS .L ontr License
CHANGE OF USE FROM
6.
ZIP39 37
PHONE
ZIP
TO
TYPE 0 NEW 0 ALT. O AD' N. 0 RPL. C MVE.
7. OF El OTHER
WORK 0 BLD. ❑ PLMB. �_ MECH. ❑ M.H. ❑ POOL
Size of Parcel
Type Const.
Zone Classification
Residential ri
Commercial ❑
Occupancy Spr'nklered
CYes ❑No DReq'd.
New Const. Valuation
Main Floor
Cover Deck
No. Baths
Certiti. of Exempt.
or Variance
Remode ed Valuation
Upper Floors
Uncv. Deck
Total Bldg. Floor Area
Garage/Storage
No. Floors
Greenhouse
Fin. Basement
No. Fin. Rooms
Unfin. Basement
No. Dwellings
Required Yes- Nor' Number
Received Yes: -7 Nor:
8.
DESCRIBE WORK install Arrow 2200 Insert into masonary
VALUATION
9
nz
SOURCE ^OO�GAS
UTILITIES
Shorelines/Flood Haza d
Yes T Not Applic.
ELECTRIC
WATER
PUBLIC C
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public Private r
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 au-
thority 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
SIGNATURE OF (?)14.1_t
'
OWNER OR AGENT __a l��l � �➢J✓; Q�C� DATE
Plans Required r
Received H
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
r_
Other (Specify)
=
TOTAL $ ��
PERMITNUMBER
04* *2000
*20.006
A *000 8
/184.6
06-06-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0°6-06-83 48475 *20.00aI-
DATE ISSUED PERMIT NO. TOTAL