1986, 10-23 Permit App: 00013797 Residence- BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
(Please return this original and your building plan;jo the Department of Building and'Safety)
3/9a
•
' 1 Owner's Name• j. - (test) (first) (m) Use Only
�Depm'iment
McGrath Michael D. R,,. V • [comm
2 Project Address (rwt Malli A[ �r v me K Space Zip /�
4a=lElleu- aa.
North.:2./P.::
7`2./2
3 City/Community
Spokane
State
Wa.
Subdivision/Plat Name -
Orchard Ave. Addi.ticn
4 Assessor Parcel No.
0/_ 5 113a 301CO / �
Lot
Block
O 7/_
f
i.* * ♦ DEPARTMENT USE ONLY * - * *
5 Sic Code
Zorn Act.#
Zone
Project No.
6 Dwell•
/ -
No. of Buildings
'. "
Sq. FL/Acre
Depth
Pk, •75
Frontage
lD
7 Set Beck -Front
(L S-1
(R)S-2
Rear
Census Tract
Module No-
initials
vi
16 Architect Firm Name I Street Address
Zip
City
Stale
Phone
-( 1
Contact Person
Phone If different than above ' ,-
Contractor Finn Name
Michael D. McGrath Construction '
Street Address
S. 4624 Van Harter
Zip
99206
City
Spokane
State
Wa. •
Phone
(509 )928-1097
Contact Person
- Mike McGrath
License No.
MCGRAMD252DC
Phone If different than above
(509 h28-105'7
8 Owner/Agent (if different than ft1 above) 03 / d */g7
/
Business Address `
9 Zip
City
State
Phone
12 Review Required
Plan Check (Y/N)
Other (Y/N)
I SEPA Exempt (YIN)
Date
15 Type Work ‘0,111dg
0 Fire
0 MH
0 Demo
raerew
0 Add/Alter
0 Replace
0 Move
❑ Other
14 Describe Work
New Duplex
• 10 Applicant Name -
Michas- D. McGrath
Street Address
S. 4624 Van Marter
11 Zip
99206
City
Spokane.
State
Wa.
Phone
(509) 928-1097
Lender -
Washington Trust Bank
Street Address
W.717 Sprague
Zip
99201
City _
Spokane
State
Wa.
Phone
(509) 455-5629
Contact Person
Jim Schurr•a
Phone if different than above
Additional lnformation „/ O
mI = q‘ 3a }5 x2- = 186 BP 44pr -
Cs✓1 = %30 X 2 = 5coo ° QI,1�'19G =
Application Type
(Standard unless
otherwise Indicated)
❑ Fast Track
❑ Early Start .
en" Environmental Health
CO 12
W. 1101 College
Room 200 •
DEPARTMENT APPROVALS
This is nota Permit
(Indicated approvals required In either "release" or "release with conditions"
space prior to permit issuance."}"
❑ Commercial;
❑ New Construction;
❑ Additional structure;/
APPLICATION fl gD -//97
❑ Residential
❑ Bldg alteration/addition
Reif ase
elease
.. cond 1
Hold 2
r
�
•
Conditions/Comments- -
Planning/Zoning: ❑ Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson - ❑ Setbacks; 0 lot w/d; 0 lot size; 0 use/zone;
O CU, variance, zone change; shoreline; 0 fence;
•.. 0 Other 40 � '
Conditions/Comments: (/
Engineers:
N.811 -Jefferson -
Conditions/Comments;
❑ Commercial; 0 Residential; 0 Flood Plain;c
❑ drainage - 0 new access/approach; 0 fence;
❑ road improvements
•,;;112-.2 5-77/
Utilities: .
N. 811 Jefferson
Conditions/Comments
Other:
Plan Exam
Fire Prev.
Conditions/Comments V\/\
Project Representative Telephone
Agencies Performing Special Inspection: - -
1
2
3
1 Indicate above or attach conditions relative to final as built approval
, 2 Indkate above or attach reasons for hold
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tr.
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PLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
IProject,'
Owner's Name Last First MI
Project Address (Street Name & Number)
City
State
Subdivision/Plat Name
Assessors Parcel 1
Lot
Block
Plata
Applicant
Address
City
I State
Zip
Phone
Business Phone
Contractor
Address
City
I State
Zip
Phone
Contact
Licensee
Business Phone
Describe Work
Bar Sink(s):
Drinking Fountaln(s):
Floor Drain(s):
Washing Machine(s)' 24,
Doh Wshr(s): 2
Garb Disp(s):
Kit Sink(s):
Lndry Tray(s):
Sew Eject(s):
Urinal(s):
Wt Closet(s):
Lav(s): 2
Shower(s):
Tub(s): 2--
Bidet(s).
Other: I Type;
Waste/Grease Interceptor(s):
Sewer Y N Septic/Health No..
Electric Water Heater(s). _.
Drains -Roof:
REPAIR OR ALTERATION: Drainage, Vent, Water Piping /Treatment • Y N
Lawn Sprinkler System(s), Including backflow device on any one meter:
Vacuum breakers or backflow devices In excess of line 16:1-5:
(Or) 5+:
MX4
/ C, 0,
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied 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 of local laws regulating construction or the performance of
construction.
SIGNATURE OF
OWNER OR AGENT DATE
APPLICATION
•
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