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2001, 09-06 Permit: 00004866 C of O WorksheetsCertificate of Occupancy Worksheet Last Update: 9/6/01 Updated by: J.D. LARSON Address: 1423 S BURNS RD Parcel #: 45234.1603 Owner: FIEBELKORN, BRE Address: 1423 S BURNS RD VERADALE, WA 99037 Project #: 00004866 Site #: 39013 Contact: FIEBELKORN, BRE Architect: Contractor: OWNER Occupant: Permit Use: CHANGE OF USE FROM RESIDEENCE TO LICENSED CARE FACILITY CO Use: 44461/-4-44.1 "31-7t/ Occupancy: LC -Ii Construction Type: ` Fire Sprinlder 0 FireAlarm ❑ (509) 228-0969 ( ) - 0 Assembly Area Room # / Location Occupant Load Special Inspection Agencies: APPROVED FOR " 4 " GROUND FLOOR SLEEPING ROOMS WITH " 4 " TENANTS WITH CLASS # 1 EVACUATION CAPABILITY AND A MAX. OF " 2 " TENANTS WITH CLASS " 2 " EVACUATION CAP. HS Bolts/ Soil / NREC Concrete Masonry Steel Welding Drainage ❑ 0 0 0 0 0 ❑ 0 0 0 0 0 ❑ 0 0 0 0 0 ❑ 0 0 0 0 ❑ Final Report Received By Inspector : HOWARD, DAN Coordinator : BURRIS, ROBIN Date Complete Intials Date Complete Intials ❑ Mechanical ❑ Drainage ❑ ❑ Landscaping / Irrigation ❑ ❑ Parking / Paving ❑ Plumbing dam:eking ssability �'' y..G'9 4-s/r ❑ Fire Sprinkler REQUIRED APPROVALS ❑ FireAlarm ❑ Fire District FD 01 ❑ Fire Iiydrants / Lock box ❑ WA DOT ❑ Critical / I-Iazardous Materials ❑ Special Inspection ❑ Grading ❑ Record drawings/Stormwater ❑ Demolition ❑ Utilities / Liberty Lake Sewer Dist. ❑ Free Standing Signs ❑ SRHD: Schools / other ❑ On Building Signs ❑ SRHD: Food Handling ❑ NREC ❑ ❑ Special Inspections ❑ Certificate of Occupancy Worksheet Last Update: 9/6/01 Updated by: J.D. LARSON Approved for TEMPORARY CO - Field Inspector: Date: Code Coordinator: Conditions: Expiration Date: Fee: Approved for FINAL CO - Field Inspector: .{/ Date: Conditions: Code Coordinator: MAIL CO TO: ADDRESS: i c" /iP�c,l�/ar4/ J7 3 _ 5 /34./,',1/5 Date Comments PI IONE: Certificate of Occupancy Worksheet Last Update: 10/24/00 Printed: 10/24/2000 Address: 1423 S BURNS RD Project #: 00004866 Parcel #: 45234.1603 Site #: 39013 Owner: FIEBELKOM, BREA Contact: FIEBELKOM, BREA- Address: RE-Address: 1423 S BURNS RD Architect: VERADALE, WA 99037 Contractor: OWNER (509) 228-0969 () - 0 Occupant: Occupancy: LC -1 Construction Type: VN Fire Sprinkler 0 FireAlarm Fes' -Use:---CHANGE--OF-USE FROM -RESIDENCE TO - * - - f' j Special Inspection Agencies: HS Bolts/ ' Soil / NREC Concrete Masonry Steel Welding Drainage Agency: APPROVED FOR #4 GROUND FLOOR 0 0 Agency: SLEEPING ROOMS FOR #6 TENANTS WITH ❑ 0 Agency: CLASS #1 & #2 EVACUATION CAPABILITY ❑ 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Final Report Received By Date Complete Intials Date Complete Intials Approved for TEMPORARY CO - Field Inspector Conditions: Expiration Date: Date: Fee: Code Coordinator. Approved for FINAL CO - Field Inspector: Conditions: ' _ Le: /e m cyCode Coordinator. ❑ Drainage • Mechanical • ❑ Landscaping / Irrigation ❑ ❑ Parking / Paving ❑ Plumbing ❑ Smoking ❑ Accessability ❑ Fire Sprinkler QUIRED APPROVALS / ..------------ ❑ Fire District FD 01 • • FireAlarm ❑ Fire Hydrants / Lock box ❑ WA DOT ❑ Special Inspection • Critical / Hazardous Materials ❑ Grading ❑ Record drawings/Stormawater ❑ Demolition ❑ Utilities / Liberty Lake Sewer Dist. ❑ SRHD: Schools / other • Free Standing Signs • SRHD: Food Handling • On Building Signs ■ NREC • • • Special Inspections Approved for TEMPORARY CO - Field Inspector Conditions: Expiration Date: Date: Fee: Code Coordinator. Approved for FINAL CO - Field Inspector: Conditions: ' _ Le: /e m cyCode Coordinator. Certificate of Occupancy Worksheet 4 . Last Update: 10/24/00 Printed: 10/24/2000 MAIL CO TO: ADDRESS: / s,'23 _,...5- Zz....,..4 PHONE: f_)A its491/ e ji. 7,0 2 Date Comments AREA . SPOKANE COUNTY NOTICE OF INSPECTION PROPERTY ADDRESS: 4/1.2S 5. / afi&n/S PROJECT NO. weo { OWNER CONTRACTOR INSPECTION TYPE: .1/70.0<r- C.42.ent STATUS OF WORK LISTED ABOVE: NC oS NOTES: Yys Y -1 BY: INSPECTOR DATE QUESTIONS? CALL OUR OFFICE: DIVISION OF BUILDING AND CODE ENFORCEMENT (509) 477-3675 CALLED IN: DATE TIME SPOKANE COUNTY DIVISION OF BUILDING AND CODE ENFORCEMENT Legal Description: Parcel .No.. 45234.1603. Owner: Bre Fi ebelkcsn Occupancy Group: l,l Construction Type: Occupied As: .... C aarkge. of. Use .frau. Res Additional Information: .. Approved or 4 g evacuation capabil ' Cy 43)-gteptog. ...r.. .ternoftto tit .flow. 1. A .11 This Certificate is issued pursuant to Se •n 109 of the Uniform Building Code and is to indicate the above described structure is approved for occupancy. Building Official's Signature THIS CERTIFICATE MUST BE PERMANENTLY MAINTAINED IN THE BUILDING OR STRUCTURE REFERRED TO ABOVE If the building or structure is used for any occupancy other than that listed, an application for change of use shall first be made to the Division of Building and Code Enforcement e4WWW •_i_ ..moi