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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. 00,.0000900M00000000 ..1.11u°k0r: r .moi LA k"‘ cot,.r,�tZ `��a,�rr �� ��vr✓lr� e tjt, to kL 'Led- 6C 2rcty• 'r.�o�t �� ���a�-1.4(z-u4L'Il,-( s1"`C Gln, y ak 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