1991, 12-09 Permit App: 91008498 Pole BldgSPOKANE COUNT? DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER- Yioo849e
APPLICATION DATE- 12/09/91
****K* i;..{ .{. ,'> { NOT A PERMIT it rf..j>'..ri :++::+;.
PENALTIES WILL is; E:: r"', , ` f: , t` ' E: I1 {= Ia F' C; (a i'i #`•{ E::'(4f:::L P'1 Cr WORK WITHOUT 6# PERMIT
SITE STREET-- 11004 E GRACE AVE
ADDRESS= 99206
i'7
PERMIT USE,. f''I.?1...1::. BUILDING
PLAT4= 000767 PLAT NAME FAIRAC
BLOCK 50 lot= a : UR -3,5
) /00:04:i "/"
1.: a i t`j'i'{•-{_ .130
" �J{:: BLDG,:;., ,1 0 DWELLINGS . WATER DIST
'{
OWNER.,, i;E•T (;f(..It•)T , MARK
STREET- 11004 E GRACE #"#L':
ADDRESS= SPOKANE KNE: PR A 9920,
509 927 7444
L::'!! (F1t: C NAME= MARK DE:.B(:io:T ( PHONE NUMBER= +'3t;4 ;•,.
BUILDING SETBACKS: FRONT= I ::.'..> LEFT= 1 ..+ RIGHT= ":> REAR= 145 . .
. s ! * n s4!+ n. b, ++, n.!. x o j+.!t * ye h. n. h n h.1+ a k n. n.n. n ••. ' r I 1. :u•i�•: n•:K J;.. 1i + � +.
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i.!f:::P'(:41•r I"l I{: -1,E 1
REVIEW W (:,(.tMMEI TS
BUILDING PLAN REVIEW REQUIRED
BUILDING SETBACK REVIEW REQUIRED
1•'11:::r I...•'€ 1'•i1):FST INCREASE E :P:N P...(:iT COVERAGE
i+7 i4*"IK..rw.*:),C* *nv•+:. :n:. :sr. rRrnp*r } 3r BUILDING i•• I::. R1"i 1:
CONTRACTOR= OWNER
INi:.{ti:::
DWELL 114 .; Fi
',TO PARKING -
APPROVAL COMMFNT
PeR.....5� Pudu.....�..... _..
JpCI. (."..' (/ ver
***W!************. *k.4
PHONE-
REMODEL-
ONE: -
OCCUR, I .
BLDG ADDITION= CHANGE �ti_.11... 3
0 SO FTx: 900 L:! , PRINIE.{..Ei'7 rj
4HANDICAP,, CRITICAL MAT N
DESCRIPTION c;Ri:i1.1f:,
POLE x:11...!.!(; 0—i
3:.1..E't DESCRIPTION
I rF'T:I.(.ijJ
RESIDENTIAL VALUATION
`.TATE::.{I.iR�;P::HAF C;E::
COUNTY .. SURCHARGE
TYPE SQ ET
VN 900
7200,00
VALUATION
QUANTITY FEE AMOUNT
99,0
PERMIT
TYPE FEE AMOUNT T AMOUN t' PAIDBUILDING PERMIT ii9„'34 ,00
" t . t.i t ' , :.:• {:: i:; is c : JULIE >' 1••i 1"# .i... {. 0
PRINTED BY: ._:1..11...:1:E:: a'P-1r'tT'T':l
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Spokane Comity
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET kDDRESS:
CITY/STATE/ZIP: J po C<C( „fie, (-t74 97,256
SUBDIVISION:
BLOCK:
LOT AREA:
a J
LCAT: ZONE :Li- DISTRICT:
# OF BUILDINGS:
F/A: WIDTH: DEPTH:
# OF DWELLINGS:
OWNER:ebc 0dt
MAILING ADDRESS:
F(/'G 7 6( -c,e.
R/W:
WATER DISTRICT:
PHONE: S9 �� - 7W/
CITY/STATE/ZIP: pok Ale (,«J J' �Ci6
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
+***************************************************************************
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
BUILDING INFORMATION
E i/66c1
Com -
ARCHITECT/ENGINEER:Q� .J(' f (l
MAILING ADDRESS: M i
PHONE:
SpOk .4)e. s / 0 6 -
PHONE:
NEW: REMODEL: ADDITION: X CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD:
BUILDING DIMENSIONS: 3C)
3o
BUILDING HGT:
STORIES:
(WIDTH X DEPTH) SQ. FT.: %%
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
DESCRIPTION OF WORK: New addition Remodel Moving Bldg. Zone _
Size of Lot /
Sewage System f -Z
Const L Dimensions Total Sq. Ft. / 6 D
(Frame, concrete. brick, etc.)
Rooms Baths Basement Foundation Const. Chi^�mey
(Full. part, none
Heat. System Type of Roofing Ext. Finish Int. «
Use of Bldg. _ � c "
No. of U
Garage or Carport Attache cJ ( Private Deta:c'r:._
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3
(..7.,)//ed buildings; (4) distance to property lines and stree ; (5) dimensions of buildings; (i
a d water supply lines.
NORTH
I het:by cert
shown
SOUTH
Plumbing Pe)
�*+ Heating Pern
NSewage Pere
PIans Receive
Plans Checke
Plans Return(
Plans Picked
Plans Mailed
subn4 tedo is correct and there are no other structures iocat�
Own- or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUC
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
4%7 -
Your street address will be
The zon: is
Sewage Permit Number Issued Building Permit / Receipt
Remarks f/
Form 523 Bldg. Code