1983, 12-19 Permit: 83B-2640 Mechanical FixturesPLAN 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
1.
STREET ADDRESS
E. 11617 - 47th
PARCEL NO.
2.
3
LOT
BLOCK
SUBDIVISION
OWNER
N.A. Stoops
MAILING ADDRESS
F. 11617 - 47th
PHONE
924-3795
PHONE
LEGAL DESCRIPTION:
Spokane, WA
ZIP
99206
Actual Set Backs in Feet to:
North 'South
East
West
4.
CONTRACTOR
Valley Fireplace
ADDRESS
L. 16610 Sprague Ave.
LICENSE EXPIRES
1/1/84
Veradale, '.dA
DESIGNER
5 Contr. License fVALLL'F-177CG
ADDRESS
CHANGE OF USE FROM
6.
TYPE ,?''NEW
7 OF
WORK D BLD. D PLMB. ECH.
PHONE
922-2780
Size of Parcel
Zone Classification
Residential l-
Commercial !-
ZIP
99037
Type Const.
Occupancy
Sprinklered
EYes ,No Req 'd.
PHONE
ZIP
TO
❑ ALT. ❑ AD' N.
RPL. D MVE.
M.H. (71POOL ❑OTHER
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required
Received
Yes r-: Nor-
Yes- No'
Number
DESCRIBE WORK
8lnstallation of LCPI Insert (LX)
VALUATION
9.
SOURCE
UTILLIITIES
GAS
into masonry fireplace
SEWAGE
SEPTIC
SEWER ❑
ELECTRIC
WATER
PUBLIC E
PRIVATE ❑
Shorelines/Flood Hazard
Yes Not Applic.
Plans Required
Received -.1!
Ownership
Public E Private C
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 he performance
of construction. SEE REVERSE I E FOR REQUIRED I SPECTIONS
SIGNATURE OF 7 ) n APPLICATION La C
OWNER OR AGENT t - [ G"� 2� " / M( -TL( IRS DATE o_ J
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
Other (Specify)
TOTAL $
PERMIT NUMBER
o
04* *20.00
*20.006
A *0.00 n
263.92
12-19-83
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEissitDl' 9 - 8 3
PERMITSPV. L'
* 2 u. U) U TIOTAL