1995, 11-20 Permit App: 95009743 Safety InspectPROJECT NUMBER= 95009743 APPLICATION
DATE= 11/20/95 PAGE= 01
****** THIS IS NOT A PERMIT ******
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= SAFETY INSPECTION FOR L. C. FACILITY
PLAT#= 002963 PLAT NAME= WOOLF ADDITION
BLOCK= 2 LOT= 5 ZONE= UR 3.5 DIST#=
AREA= 00000000 F/A= F WIDTH= 90 DEPTH=
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= SIMNIONIW, DAN
STREET= 1712 S EVERGREEN RD
ADDRESS= VERADALE WA 99037
F
138 R/W= 60
PHONE= 509 922 7451
CONTACT NAME= DAN SIMNIONIW PHONE NUMBER= 509 999 2306
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
******************************* BUILDING PERMIT *******************************
CONTRACTOR= OWNER
NEW=
DWELL UNITS=
BLDG W X D =
REQ PARKING=
REMODEL=
1 OCCUP. LD=
X SQ FT=
#HANDICAP=
PHONE=
ADDITION= CHANGE OF USE= X
BLDG HGT= STORIES=
SPRINKLER= N
CRITICAL MAT= N
ITEM DESCRIPTION QUANTITY
STATE SURCHARGE
CHANGE OF USE/SAFETY INSP
PERMIT TYPE
Y
Y
FEE AMOUNT AMOUNT PAID
BUILDING PERMIT 54.50
54.50
PROCESSED BY: JOHN LARSON
PRINTED BY: JOHN LARSON
FEE AMOUNT
4.50
50.00
AMOUNT OWING
.00 54.50
.00 54.50
******************************** THANK YOU ************************************