2002, 08-26 Permit App: 02007311 Change of UseProject Number: 02007311 Inv: 1
Applicatiqn
Date: 8/26/02 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: CHANGE OF USE TO ADULT FAMILY HOME (5
TYPE S CLIENTS)
Setbacks: Front
Site Information:
Plat Key: 001869 Name: ORCHARD AVENUE ADD REPLAT District: H
Lot:
Left: Right: Rear:
Contact: BREWER, LORIE ANN
Address: 8110 E GRACE AVE
C - S - Z: SPOKANE, WA 99212
Phone: (509) 921-6641
Group Name:
Project Name:
Parcel Number: 45072.4202 Block:
SiteAddress: 8110 E GRACE AVE
SPOKANE, WA 99212
Location:: SPO
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Owner: Name: BREWER, LORIE ANN
Address: 8110 E GRACE AVE
SPOKANE, WA 99212
Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information �nh
Review
Plan Review
040100
Released By: 014'
Septic System Review
Permits:
Savage -system designed
forbedrooms only.
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Operator: CKF Printed By: CKF
Print Date: 8/26/02
Project Number: 02007311 Inv: 1
t
Application
Date: 8/26/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Building Permit
Firm: OWNER
Phone:
Building Characteristics
Const Category: Change Of Use Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height:
Bldg W x D: x Building Sq Ft: Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials: 0
Item Description
CHANGE OF USE/SAFETY INSP
STATE SURCHARGE
Notes:
Payment Summary:
Permit Type
Building Permit
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Stories:
Fee Amount
$50.00
$4.50
$54.50
Fee Amount Invoice Amount Amount Paid Amount Owing
$54.50
$54.50
$0.00 $54.50
$54.50 $54.50 $0.00 $54.50
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: CKF Printed By: CKF
Print Date: 8/26/02