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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 tsr( clto ******************************* 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 a - Ad- ?Cc 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. eseagliatII9t —we�mm 2 R 2 , i �I-rcHr=rJ r120ti-r f'`c rn rJNtPc\ o tr-� Ialos�'r \-3 co 2eoM eAs cwt.2+u� 4_ la 0 • Zr owes /3 +43 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) e �I tat / j?jJj.�r.:+ -i- L/� boLJ 1i;! r LIRt: PLA en) 5 DSHS 21-054 (nEV. 0593) at toto 0. 0d 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" C_ , n�.Nni. `tea j 1, 8 2a. 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. a) N . m