1990, 08-03 Permit: 90003636 Relocate Residence for AdditionSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit /application, state that the information contained in it and submitted by me or my agent to compile said permit /application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS /NOTICE
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit /application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 90003636
DATE= l j / t,;.3f t;i r.', PAGE= 01
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SITE STD_ = 1402 E ADAMS RD
VERADALE WA 99037
PARCEL4- 23543-2501
PERMIT ! 1 — R E L O C A T E r RESIDENCE r ? ; ADDITION . f Lx I ; s'" '" . RESIDENCE
PLATO= 002751 PLAT NAME- VERA
BLOCK= 1, i, # • ::: ,. t`,j t•• :::: (:i (x i •.: 1, t, .i. ,'; t n..... 2960 ,..
(1WNI::.#=,,°x:: t..t..!!.. i !IMMIE PHONE- >, ??) 928 468
STREET= 1 .::} , i' ADAMS
ADDRESS= V t::.1"t. t -•! i,? {••! t... t::. t, i {..:
CONTACT .: , t " t _ FOUST NUMBER= .
509 928 4681
BUILDING SETBACKS: FRONT= EXIS LEFT= RIGHT= 75 REAR= EXIS
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CONTRACTOR= OWNER {-:;.., ('i N1::: =
NEW=
!-tWEI._I_. UNITS.
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22 <. 40 :'t,! I°f•c..
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ADDITION= CHANGE OE USE=
BLDG I t r t :::: STORIES=
8 '))) SPRINKLER= •tj
CRITICAL i r•` • (• : ::: N
DESCRIPTION ! :; , ,, #,.! _,! F TYPE ,:; #,, FT VALUATION
BASEMENT U R-3 f,j 880 7920,00
ITEM Et "t .t?E,'•t.:RI!' 1 ION QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION T 99,00
e
STATE S#..!I'4�:L.f!;; #I;?(yi.:. T 4 , `,
COUNTY SURCHARGE nr to ,
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CONTRACTOR= t.! vi N C:.1•r,
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RELOCATION PERMIT
*********************K*)**
ITEM DESCRIPTION QUANTITY FEE AMOUNT
4EI...t. ?Cr'I I i.!..!N INSPECTION •# 50A00
*+)'*'* .t,..ti;: * •p; },,, •n: ?`: * 9k 9t :* ;q..t ?. j,: _, {. * fit- •tC i* 7C 7k :R' •tt •N::t.. PAYMENT SUMMARY 9i• iR• 9i' ik•.`i i }•`. yi *.0 9r a- iii- . ?-.;• • ? ?' * •:R• it-.G 9Y 9': ?b 4e• ;n• •tr tg ; ?• 9?
PAYMENT ,.? i-•1 ! #::. P is :: !::: i::: is {.: # .,,. PAYMENT AMOUNT
4386 •1 , ^t'-r' .. 3 4
TOTAL DUE= „00 TOTAL PAID= i69,34
PERMIT # .{ P'r : :: FEE AMOUNT AMOUNT PAID •AMOUNT OWING
119.34 119,34 , ?•0
50,00 50.00 .00
169,34 169,34 ,0
BUILDING PERMIT
RELOCATION ERMT
1••'1•,;(:# #..: t :.,:: ,t::.. #.) BY: (?+t .t i!.)I'.L , !9t...t.:F :i• F'i
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