1982, 11-19 Permit: 82B-1212 InsertPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES
1.
JOB ADDRESS
S. 4616 Bowdish High Ct.
— PRESS HARD TO MAKE 3 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
3.
OWNER
ADDRESS
Maurry Cauchon
PHONE
926 6303
S. 4616 Bowdish High Ct.
ZIP Actual Set Backs in Feet
North 'South
Size of Parcel
CONTRACTOR
Valley Fireplace, Inc.
PHONE
922 2780
lEast
'West
Zone Classification
4. ADDRESS
E. 16610 Sprague AVO.
VPrAr1 TAS WA
DESIGNER
Contractor License No. VA LL E"
5. ADDRESS S26 Die
ZIP 99037
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
6.
CHANGE OF USE FROM
TO
PHONE
ZIP
Valuation
Building Area in Sq. Ft.
Main Floor
Upper Floors
Garage Area
Area of Decks
Finished Basement
Storage
Unfin. Basement
7.
TYPE
OF
WORK
NEW ❑ ALT. ❑J'N. ❑ RPL. ❑ MVE.
❑ BLD. I=1PLMB. J1MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK Install "Earth Stove" Model C -201R
8. Fire -lace Insert into masonry fire-Jlace with heart
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
I. extension.'
Req'd.
Rec'd.
Not Req'd.
SEWER
Ownership
Public ❑ Private ❑
USE CODE
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 authority 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
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
4
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
04* k2000
*20.006
A *000
121.1
1 1 ;-1 9-82
z 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1,1-0-82
DATE ISSUED
121,22
*20,0-011-2,
PERMIT NO. TOTAL