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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