1995, 07-05 Permit App: 95004955 AdditionPROJECT NUMBER= 95004955 APPHICATfON DATE= 07/05/95 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
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SITE STREET= 1104 N HERALD RD
ADDRESS= SPOKANE WA 99206
PARCEL#= 45171.0905
PERMIT USE= REC ROOM ADDITION
PLAT#= 001835 PLAT NAME= OPP.TR. 1-354
BLOCK= LOT= ZONE= UR 3.5 DIST#= E
AREA= 00000000 F/A= F WIDTH= 97 DEPTH= 300 R/W= 40
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST = UNKNOWN
OWNER= WITKOE, DAVID
STREET= 1104 N HERALD RD
ADDRESS= SPOKANE WA 99206
PHONE= 509 922 2323
CONTACT NAME= DAVID WITKOE PHONE NUMBER= 509 922 2323
BUILDING SETBACKS: FRONT= NA LEFT= 6 RIGHT= 50+ REAR= 200+
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
--------------------------------------------------------------- -
BUILDING PLAN REVIEW REQUIRED Z '�
COMMENTS:
BUILDING
COMMENTS:
'HEALTHDIST
COMMENTS:
*************
SETBACK REVIEW REQUIRED
CONTRACTOR= OWNER
NEW= REMODEL=
DWELL UNITS= 1 OCCUP. LD=
BLDG W X D = 19 X 19 SQ FT=
REQ PARKING= #HANDICAP=
DESCRIPTION GROUP TYPE
RES ADD R-3 VN
PHONE=
ADDITION= X CHANGE OF USE=
BLDG HGT= 9 STORIES= 1
380 SPRINKLER= N
CRITICAL MAT= N
SQ FT VALUATION
380 22040.00
i
5
PROJECT NUMBER= 95004955 APPLICATION
ITEM DESCRIPTION , QUANTITY
------------------------- --------
RESIDENTIAL VALUATION Y
STATE SURCHARGE Y
RESIDENTIAL SURCHARGE Y
PERMIT TYPE FEE AMOUNT AMOUNT PAID
--------------- ------------- ------------
BUILDING PERMIT 280.62 .00
------------- ------------
280.62 .00
DATE= 07/05/95
FEE AMOUNT
234.00
4.50
42.12
AMOUNT OWING
------------
280.62
------------
280.62
PAGE= 02
PROCESSED BY: DAWN DOMPIER
PRINTED BY: DAWN DOMPIER
******************************** THANK YOU ************************************
What is the JOB SITE address?
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APPLICATION INFORMATION
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Legal description as it appears on the property deed
ASSESSORS tax parcel number?
14517 , 07�_
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OWNER
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OWNER or OCCUPANT
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Phone
Mailing address n
Who should we contact regarding this project?
ity, state
Zip
Phone
What work is being done under this permit?
L2 ki(f CoA
Building height
# of stories
Contractor
t mensions
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?
Manufactu
red 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
Paint booth Fire Alarm
Tent
Fireworks display _
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
Fuel Storage; Tanks`'
Swimming'; Pool
(Circle one) Above -ground
Underground
Contents of tank(s)
Contractor
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Wa State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
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INCLUDE THE FOLLOWING:
❑ All roadways, driveways & easments ❑ Underground utilities
❑ Distances from center of roads, right of ways, ❑ North arrow
private roads & property lines ❑ Septic tanks & wells
13 All existing & proposed buildings
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