1996, 02-20 Permit App: 96000783 Safety InspectPROJECT NUMBER= 96000783
A!'PLIC::TION
DATE= 02/20/96 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 1702 S EARLY DAWN DR PARCEL#= 45262.3307
ADDRESS= VERADALE WA 99037
PERMIT USE= SAFETY INSPECTION — ADULT FAMILY HOME
PLAT#= 003084 PLAT NAME= EARLY DAWN 2ND ADD
BLOCK= 22 LOT= 7 ZONE= AGSUB DIST#= F
AREA= 00000000 F/A= F WIDTH= 70 DEPTH= 135 R/W= 50
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = VERA
OWNER= BINDER, WILLIAM & PEGGY
STREET= 1702 S EARLY DAWN DR
ADDRESS= VERADALE WA 99037
PHONE= 509 927 7992
CONTACT NAME= WILLIAM OR PEGGY BINDER PHONE NUMBER= 509 927 7992
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
****************************** REVIEW INFORMATION *****************************
DEPARTMENT
REVIEW REQUIREMENT
BUILDING PLAN REVIEW REQUIRED
COMMENTS:
HEALTHDIS NEW OR ADDITI�ONNAeL^WASTE WATER AdJ,'IiW 2t /�.i �YK O✓
COMMENTS a t.LJC- 4 ! 0.24,7_,--TER
24,7_I—l /63 p y 471 CFi
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*******************************
CONTRACTOR= OWNER
BUILDING PERMIT
PHONE=
NEW= REMODEL= ADDITION= CHANGE OF USE= X
DWELL UNITS= 1 OCCUP. LD= BLDG HGT= STORIES=
BLDG W X D = X SQ FT= SPRINKLER= N
REQ PARKING= #HANDICAP= CRITICAL MAT= N
DESCRIPTION GROUP TYPE SQ FT VALUATION
ADULT HOME LC VN .00
ITEM DESCRIPTION'
QUANTITY FEE AMOUNT
STATE SURCHARGE Y
CHANGE OF USE/SAFETY INSP Y
PERMIT TYPE
4.50
50.00
FEE AMOUNT AMOUNT PAID AMOUNT OWING
t l4Q
PROJECT NUMBER= 96000783 APPLICATION •'" DATE= 02/20/96 PAGE= 02
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 54.50 .00 54.50
54.50
.00 54.50
*******************************************************************************
* PROJECT NOTE: TOPIC = CONDITIONS DEPT = BUILDING *
*******************************************************************************
MAXIMUM (6) CLIENTS - LEVEL I ONLY
PROCESSED BY: JULIE SHATTO
PRINTED BY: JULIE SHATTO
******************************** THANK YOU ************************************
I aatmglon Stale
rDEPARTMENT OF
SOCIALGHFAI.TII
SERVICES
• AGING AND ADULT SERVICES ADMINISTRATION
FIRE SAFETY EVACUATION PLAN
WAC 38876-20O(14)
DATE
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An Adult Family Home shall have a posted plan for evacuation to safe areas in event of fire. Draw a diagram of the floor plan
of your home in the space proveded below. Indicate escape routes and designate where staff and residents should meet
outside the residence. Indicate the location of fire extinguisher(s) and smoke'detector(s).
INSTRUCTIONS: Provider/Resident Manager completes and posts in a conspicuous location.
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EMERGENCY EGRESS REOUIRMENTS
FROM SLEEPING ROOMS
11 NET CLEAR OPENING - 5.7 SQUARE FEET
21 NET CLEAR OPENING HEIGHT• 24 INCHES
3i NET CLEAR OPENING WIDTH - 20 INCHES
41 FINISHED SILL HEIGHT - 44 INCHES ABOVE
FLOOR (MAX)
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APPLICATION INFORMATION
'What is the JOB SITE address? ASSESSORS tax parcel numbeR
Illo . CR.eu/ D4W D2 . 2-F3_,�a,-, �a(
Legal description as it appears on the property deed r"
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OWNER or OCCUPANT Phone
L3 t /U t is, en - each G i roc Lx) Sag - 9 a-'> - 7/9 a_
Mailing address City, state Zip
I `(U a. S. Eiti-f l.Ll DALOIIl DQ_ 0,R_2 OALG u3 Pc q9037
Who should we contact regarding this project? Phone
What work is being done under this permit?
Oasaunaiceui ��2rn/ i rot/Ice I1 dam CCS l rrl /j�
Lone
Inspector district
Property size
Hight of w dth
district
il.Water
Building
Building height
# of stories
Contractor
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
2nd floor area
Finished basement area
Architect/Engineer
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
Man_ u f a ctured Home ,°, ::
Sign - :.
Width:
Length:
What is the square footage of
the sign face)
How high is the sign?
Year:
Make:
Installer
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Meiling address
Relocation . '
Fire Safety
Previous address
"
Fire Sprinkler Tent
_ _
Paint booth _ Fire Alarm _ Fireworks display
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
Fuel-Storage:Tanks ..-7.
Swimming Pool::'::: -:.. •
(Circle one) Above -ground Underground
Size / gallons
Private
Contents of tank(s)
Size / gallons
Public/semi-private
Contractor
Contractor
Wa State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
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