1982, 12-07 Permit Application: 82B-1766 Fireplace Furnace InsertPLAN NUMBER
STREET ADDRESS
1.
2.
3.
LOT
OWNER
BLOCK
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
N. 23 Adams Rd.
SUBDIVISION
Lewis Purcell
MAILING ADDRESS
N. 23 Adams Rd
PHONE
928 4054
CONTRACTOR LICENS E PI ES
Valley Fireplace In 1/1/853
4.
ADDRESS
L . 16610 Sprague Ave.
•
DESIGNER
ADDRESS
✓ er adale,
CHANGE OF USE FROM
TYPE ❑ NEW
7. OF
WORK ❑ BLD. ❑ PLMB. E"MECH. ❑ M.H.
PHONE
ZIP
PHONE
922 2780
ZIP
99037
PHONE
ZIP
TO
❑ ALT. ❑ AD' N. ❑ RPL.
❑ MVE.
❑POOL ❑ OTHER
DESCRIBE WORK Install "Blaze Princ
Insert into masonr fireplace w
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
Fireplace Furn
ear eRR ension.
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 'South
1East
West
Size of Parcel
Type Const.
New Const. Valuation
Main Floor
Zone Classification
Residential ❑
Commercial ❑
Spr'nklered
❑Yes ❑No ❑Req'd.
Remodeled Valuation
Cover Deck
No. Baths
Total Bldg. Floor Area
Garage /Storage
Uncv. Deck
No. Floors
Certifi. of Exempt.
or Variance
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes❑
Received Yes
No ❑
No❑
Shorelines /Flood Hazard
Yes❑ NotApplic. ❑
Ownership
Public ❑ Private ❑
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 taw regulating construction or the performance
of construction. SEE REVER SI OR REQUI ' INSP TIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE
SPECIAL APPROVALS SPECIAL • DITIONS: (SEE Rfr/ERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
1tech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
b;"--E5 -74
04* *20,00
*20.006
A *0,00 8
17652
12 -08 -82
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEJIS2UEW 8 - 8'2
PERMIT'NO.6' 6
*2 a 0 q.,3-,AL
iL
W
-.d
LL
ArrLJI.A I I0I4 / lGNIYI I I
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
8011711 1I1 JEFFERSON / SPOKANE, WASHINGTON WHO / (WA 455 -34*5
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
'TAPE Aron
)7, 23 Adams Rd.
A(2 )
PARCEL NO.
3.
TOT NOON 1 RAUn/15Kw
OWN
Leis Purcell
wASIANG .120.
N. 23 Adams Rd
9'LB 4054 iM
EGAL DESCRIPTION:
COn �`eC�OF Valley Fireplace InV MS"
4. ,,cooa
E. 16E10 Sprague Ave.
A Perot
922 2780
roe 0r,no,w on+DD
99037
LE PA
. or n•Inle. .�1.
5. •vv0505
00..•95OF TOEPA^P TO
. OAM.O.A.A. I. , .w:,�, wN.eP
a
M.O.. ta9r Fmn 4Nap Ge.n•
mwm Fa.. e.....,
TYPE 0 NEW D ALT. 0*D•N. 0 RPL. D SIVE.
7. OF D OTHER
D BLO. L. /M.
WORK
NA
wa a T.D Mau
.O
b
a.. aye ..O D
Ra..a ❑
8 n"��serSntp IrstoNl y iie p 1pre Tnl erppth SSrevt an ivwn4e
7,.74"""Z:=1
03400 *aN sOUXCE SAS 1 ELECTRN: I , 0 SErrii�
,E� D SEWER❑ AATA ❑Woe.❑
nereoy malty tMt I nays read and •umI*.d I5N &POlkallon and haw read IN 'NOTICE' Provision. Included on
u side, and EM. IM urns to W Inn Nth oWreal• All woN•th• 01 AAA, and ordinances oovernino INN type of
+wh .ill M aomplleO.Il* Hamner apclfNd ANON w eel. TIN Qnn11nQ 01 • permit does not presume 10 910. au.
nor111 N 40141. w canal the 0*0Halone of any other stale of them 150 requialInq en•rucIlon w IM perlwm•nc4
olu•00,i *an. SEE REV ER 51 •. OR REOUI _,sr IN5P TIONS
WNATU OROE NT APPLICATION
DATE
CIAL APPROVALS SPECIAL •'a IONS: (SEER EESE SIDE FOR NOTICE)
P,ELIN ANAL DATE
EAT.*
PA
Puna
PERMIT 15 NONTRANSFERABLE
Nsnw
FEES COLLECTED
84'034
NOny,N
TOTAL f
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
OWNER
INSPECTION RECORD
CONTRACTOR
N S E W
SET BACKS
LOCATION
TYPE OF WORK
FINAL INSPECTION: 1 i6 -f3 Pi 4
DATE REMARKS:
z„,
iiisei- f j ;q 1, U a 7
�r( 57lie1 lzczs