1996, 04-12 Permit App: 96002103 RemodelPROJECT NUMBER= 96002103 APPLICATION
DATE= 04/12/96 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 10624 E EMPIRE WAY
ADDRESS= SPOKANE WA 99206
PERMIT USE= REMODEL GARAGE INTO DEN
PLAT#= 001038 PLAT NAME=
BLOCK= 8 LOT=
AREA= 00000000 F/A=
# OF BLDGS= 1 # DWELLINGS=
OWNER= BAGBY, MARK
STREET= 10624 E EMPIRE WAY
ADDRESS= SPOKANE WA 99206
PARCEL#= 45054.0608
GRANDVIEW ACRES
3 ZONE= UR 3.5 DIST#=
F WIDTH= DEPTH=
1 WATER DIST = IRVIN
H
R/W= 40
PHONE= 509 927 7283
CONTACT NAME= PAT DURBIN PHONE NUMBER= 509 993 6918
BUILDING SETBACKS: FRONT= EXIS LEFT= EXIS RIGHT= EXIS REAR= EXIS
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING PLAN REVIEW REQUIRED
APPROVAL: R BURRIS / JDL
HEALTHDIST
COMMENTS:
NEW OR ADDITIONAL WASTE WATER
DATE: 04/04/96
/74-"-
******************************* BUILDING PERMIT *******************************
CONTRACTOR=
STREET=
ADDRESS=
NEW=
DWELL UNITS=
BLDG W X D =
REQ PARKING=
EMERGENCY HANDY MAN
126 S MITCHELL CT
LIBERTY LAKE WA 99019
REMODEL= X
OCCUP. LD=
X SQ FT
#HANDICAP=
DESCRIPTION GROUP TYPE
REMODEL R-3 VN
ITEM DESCRIPTION
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE'
PHONE= 509 993 6918
• ADDITION= CHANGE OF USE=
BLDG HGT= STORIES=
SPRINKLER= N
CRITICAL MAT= N
SQ FT VALUATION
264 6250.00
QUANTITY FEE AMOUNT
Y
Y
Y
107.75
4.50
23.71
PROJECT NUMBER= 96002103 APPLICATION DATE= 04/12/96 PAGE= 02
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 135.96 .00 135.96
135.96
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: JOHN LARSON
.00 135.96
******************************** THANK YOU ************************************
APPLICATION INFORMATION ` 210-n
What is the JOB SITE address?
ASSESSOR'S tax parcel number?
505� o(c)®672
Legal description as it appears on the property deed
•e.,41--6/ (ew .11
OWNER or OCCUPANT
Mailing address
Who_should we contact regarding this project? l
Phone
City, state
--_pioi4t\l't (AA
Phone
Zip
What work is being done under this permit?
Building height
# of stories
Contractor
Kkl) a if\idv\f\a_N)
WA State Contract license #
Dimensions
TOTAL SQUARE FOOTAGE
co
Mainfloor
Unfinished bass ment area
Mailing address
5) YY1.1 )-c ) LL
Architect/Engineer
2nd floor area
Garage area
cp
Finished basement area
Size of decks, etc.
What i ''1 h15-52.1 )100 '41
4
What is the cost of your project( 5
Manufactu
red Home
Sign
Width:
Length:
What is the square footage of
the sign facet
How high is the sign]
Year:
Make:
Installer
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
•
Relocation
Fire Safety;:
Previous address
Fire Sprinkler _
Paint booth Fire Alarm
Tent
Fireworks display
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
Ftet Storage Tanks,
Swimming Pool
V1
(Circle one) Above -ground Underground
Contents of tank(s)
Size / gallons
Size / gallons
Private
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 programa or activities.