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1988, 12-14 Permit App 88004006 MasonryINFORMATION WORKSHEET PERMIT USE: S CONTRACTOR. LICENSE NUMBER: - CONTRACTOR:: PARCEL NUMBER: 3 -?�-98.-7 / STREET ADDRESS: E. 14324 Broadway CITY/STATE/ZIP: Spokane, WA 99206 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: f42 C-W F/A: WIDTH: C DEPTH: f (k R/W: #.OF BUILDINGS: A OF DWELLINGS: WATER DISTRICT: ik Jj1- CY0.Lr(.15 OWNER: J. T. & Mary Kapper PHONE: 206 226=1700 MAILING ADDRESS:.. 15914 S.E. 182nd Place, Renton; WA 98058 CITY/STATE/ZIP: Dorothy M. DeCroff, Manager CONTACT: Prim Group, Inc PHONE: 509 - 922. - 3944 SETBACKS: - FRONT: LEFT: RIGHT: REAR: .� BUILDING INFORMATION PHONE: MAILING ADDRESS: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: BUILDING DIMENSIONS: STORIES: X (WIDTH-X DEPTH) SQ. FT.: REQUIRED PARKING: HANDICAP: SEWER (Y/N): HYDRANT: MN mizaren now NES .®e 0131, al NMI H Mal 1111W ratil® a /®®i infer 134N,R r, sE aran� Prnvlrlpllr;p Spokane, WA 99207 SOOT NORTHSIDE •483- 7668 SOOT SOUTHSIDE •838- 7668 SOOT VALLEY •922- 7668 "Your Safety is Our Service" Stale Contractor's Registration No. OA-KENG52,OLH WORK PaRFORMED r 'f /3- u risll�� r� �1 it r rr. �h r CUSTOMER COMMENTS ApeRe R PAYMENT (`-'lease Include Invoice Number with Payment INSTALLE CUSTOMER ADDRESS CITY PHONE l,i A /2'✓27L 1 Nam= DATE/ lA2 ka //'CZ. !..C.J 1 STATd L/ ZIP TIME RECOMMENDATIONS sr_ 17( irk r; Inc oprrt WORK P RFORMFD gr SUB TOTAL f , 6-1C+2..1? , a 9-Vgju s- nature KTi7� utallerr s i. ignatur.e.n 'x 3RD'DEGREE CREOSOTE• PRESENT. 'A hard or I sticky tar normally caused by wet or green wood, long enods between cleanings, very low fires or combinations of all. There la/ be enough creosote remaining for an immediate chimney e co TOTAL NOTE: This sheet is the result of a visual inspection done at the time of cleaning. It is intended as a convenience to our customers, not as a certification of fire worthiness or safety. Since conditions of use are beyond our control, we make no warranty of the safety or function of any appliance and none is to be implied. OAKENSHIELD CHIMNEY SERVICE FLUE ZiiER -- FLUE 1 LINTEL / i i DAMPER � FIREBOX 1111 i HEARTH ASH PIT _ DOOR CHIMNEY CAP SMOKE CHAMBER SMOKE SHELF \ THROAT ASH DUMP ASH PIT