1995, 12-04 Permit App: 95010103 Egress WindowsPROJECT NUMBER= 95010103 APPLICATION
******
THIS IS NOT A PERMIT
DATE= 12/04/95 PAGE= 01
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 1712 S EVERGREEN RD
ADDRESS= VERADALE WA 99037
PARCEL#= 45271.3305
PERMIT USE= INSTALLING 2 BASEMENT EGRESS WINDOWS
PLAT#= 002963 PLAT NAME=
BLOCK= •2 LOT=
AREA= 00000000 F/A=
# OF BLDGS= 1 # DWELLINGS=
OWNER= SIMNIONIW, DAN
STREET= 1712 S EVERGREEN RD
ADDRESS= VERADALE WA 99037
WOOLF ADDITION
5 ZONE= UR 3.5 DIST#= F
F WIDTH= 90 DEPTH= 138 R/W= 60
1 WATER DIST =
PHONE= 509 922 7451
CONTACT NAME= DANIEL SIMNIONIW PHONE NUMBER= 509 922 7451
BUILDING SETBACKS: FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
****************************** REVIEW INFORMATION *****************************
DEPARTMENT
BUILDING
COMMENTS:
REVIEW REQUIREMENT
PLAN REVIEW REQUIRED
******************************* BUILDING PERMIT *******************************
CONTRACTOR= OWNER
NEW=
DWELL UNITS=
BLDG W X D =
REQ PARKING=
REMODEL= X
OCCUP. LD=
X SQ FT=
#HANDICAP=
DESCRIPTION GROUP TYPE
WINDOWS LC VN
ITEM DESCRIPTION
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
PERMIT TYPE
FEE AMOUNT
PHONE=
ADDITION= CHANGE OF USE=
BLDG HGT= STORIES=
SPRINKLER= N
CRITICAL MAT= N
SQ FT VALUATION
400.00
QUANTITY FEE AMOUNT
Y
Y
Y
35.00
4.50
7.35
AMOUNT PAID AMOUNT OWING
PROJECT NUMBER= 95010103 APPLICATION
PERMIT TYPE
DATE= 12/04/95 PAGE= 02
FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 46.85 .00 46.85
46.85
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: BURRIS, ROBIN
********************************
THANK YOU
.00 46.85
************************************
d
toto
O.
O
APPLICATION INFORMATION is ` (C7 l03
'What is the JOB SITE address? ASSESSORS tax parcel number?
/ 7/ . . 4 e
LC
Legal description as it appears on the pro rty deed
OWNor OCCUPANT
(44/1 IP_(
Phone
L r tS/ w, 0(oN 9,,?-7gr1
Maili address ^ City, st to Zip
A 11/6/
t 71 C9 S . v-eA V-ee-14.- u"),4. 99037
Who
ho�tsh)
J//A
should we contact regarding this proj Phope -
AA f 142 I ', - ) Si / NA /-! (O n / !ate
What work is being done under this permit?
t
-----C/t-5A-1� P sol r A vas di� e° D 5_:
Lone
Inspector district
Prope s
Right of way width
Water district - -.:::.-
Building
Building height
# of stories
Contractor ``�A
/�WCC(r_t
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?
Manufactured 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
Mailing 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 -H- ..::;:. _
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*
A State Contractor license #
Mailing address
Mailing address
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programa or activities.
n
w