1983, 01-26 Permit: 83A-0650 Change of UsePLAN NUMBER
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
1.
STREET ADDRESS
Sr
iSS -bisanei'pa
iN�tc.,A
PARCEL NO.
2 544" - 19j05
LOT
2.
BLOCK
SUBDIVISION
OWNER
3 2--c7 c 2T
MAILING ADDRESS
�. l5tn
CONTRACTO
4.
H
PHONE
PHONE
etz.8-I143
ZIP
037
LEGAL DESCRIPTION:
Actual Set Backs In Feet to:
North ISouth
East I Wast
LICENSE EXPIRES
PHONE
Sim of Parcel Zone Classification
I AC. A647-1 •
Residential 0t,„0"
Commercial
ADDRESS
ZIP
Type Cant. Occupancy Sp nklered
DYes DNo 0Reg Id.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
CHANGE OF USE FROM
6. T2e5 t Oc c -e
ZIP
/4 4/ ryUASEIZy
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE 0 NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF BLD.
LD.
0 PLMB. 0 MECH. 0 M.H. 0 POOL
E5THER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Gerbil. of Exempt.
or Variance
Required VesO No❑
Received VesO No0
Number
DESCRIBE WORK
8. Gni=tcy_
VALUATION
9.
Shorelines/ Flood Hazard
VesO Not Apolic.0
Plans Required 0
Received 0
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
I hereby certify that I have read and examined this appl cation 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 law regulating construction or the performance
of construction. SEE REVS E R'R OUIRED INSPECTIONS
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
wfl
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Lic_exsth,so
Cofz tom,tAtc-Dtc'W
aomaknce.
htt
(A), Mirsr�/ef 4,//"n, . 444y 4i!/Z4))4/Q-)
PERMIT 15 NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
_ IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
50 -
Other (Specify)
TOTAL $.
PERMIT NUMBER
02* *5000
*50006
A *000 8
6492
01-26-83
`2 647'9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMESA PERMIT.
t.h .
DATE £3E6'.'2 .6 418P3j
PERMIT NO. •5. 0 z
*'50.0 ort L
C
0
4
14
anc 1 1 ane . ex,ce arki ngieA
(r;ed 'rAct
ciicscnt Cent°,
a
049
)3-1
>ItO
DICK MARQUARDT
•
STATE INSURANCE COMMISSIONER
AND STATE FIRE MARSHAL
James L. Manson
Director, Dept. of Building
and Safety
County2of Spokane
811 North Jefferson Street
Spokane, WA 99201
STATE OF WASHINGTON
OFFICE OF
STATE FIRE MARSHAL
January 12, 1983
kECEIVED
BUILDING CODES
TOM BRACE
DIRECTOR, DIVISION OF
STATE FIRE MARSHAL
REPLY 10
OLYMPIA OFFICE
INSURANCE BUILDING
OLYMPIA, WASHINGTON 98504
753-3605, AREA CODE 206
s:: -)NICIIMEE
Nal'
Dear Mr. Manson:
RE: NOTIFICATION OF INTENT TO ESTABLISH CHILD CARE FACILITY
The Child Care Licensing Unit, Department of Social and Health Services,
has instructed the' State Fire Marshal to -inspect a facility located' in
your jurisdiction, seeking licensure as a child care facility. The
State Fire Marshal will accomplish a licensing inspection of the facility
to determine compliance with the appropriate 212 Series, Washington Ad-
ministrative Code (WAC).
Specific details regarding the facility, license applicant, type of
license applied for, and anticipated occupant load are identified on the
attachment to this correspondence. The information is forwarded to your
office to enable you to establish contact with the license applicant,
pursuant to securing compliance with the Uniform Building Code, or any
other appropriate local ordinances. The attached is for information only;
no further reply to this office is necessary.
Please advise the Fire Chief, or the agency charged with -the enforcement
of the Uniform Fire Code, of the intent to establish a Child Care facility.
A fire safety inspection should be accomplished to ensure compliance with
the Uniform Fire Code, or any other local ordinances relating to fire pro-
tection. No further reply to the State Fire Marshal's Office is necessary.
Sincerely,
GEORGE WILLIAMS, Supervisor
Residential Inspection Division
GW/sf
Attachment
e 3
1.LPROPEF^Y TO BE INSPECTED
1 COUNTY: Spokane..—.-..._._.____.
2 INSPECTION REQUESTED BY •
_____ _
lREQUESTOR
„mx? Specially for Children Enrichment Ctr.
NAME,, 1. • ,- i
ADDRESS: S.2505 Dishman'Mica Road
AGENCY: DSHS - Re.ion 1
CITY Spokane, WA CODE: 99206
ADDRESS: W.1101 College, Rm.360
CITU: S.okane ZIP
CODE: 99201
PERSON CONTACT. Randa Jewett PHONE: 928-1193
PERSON
OTCONER TACT:
TO COMA
TO CT: PHONE:
�(g 545)456-6316 DATE: 1 6 83
3.
TYPE INSPECTION REQUESTED
-LICENSING INSPECTION
NEW
XX
REINSPECTION
_ REQUESTED OR LICENSED OCCUPANT LOAD
RENEWAL
BPECIAL INSPECTION
INSPECTION, OTHER:
NO.: 40
AGEGRO1 TO 10 YE
CURRENT LICENSE PLEASE
EXPIRES ON: REPLVBY: ASAI'
OTHER:
4. FACILITY TO BE LICENSED AS_,J,.,'/�e/_����,`,
FAMILY DAY CARE CENTER RESIDENCE) '
(IN GROUP CARE FACILITY TRANSIENT ACCOMMODATION Coo a
DAY CARE CENTER (IN RESIDENCE)
MATERNITY SERVICE OTHER.
XX DAY
CARE CENTER (NON RESIDENCE) _� DAY TREATMENT PROGRAM
INFORMATION
REQUESTED: .