1988, 02-19 Permit App: 88000285 Residence AdditionSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
NORTH 811 JEFFERSON
SPOKANE, WASHINGTON 99260
(509) 456-3675
1 certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct. In
addition, "we 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 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
{:%11lNUMBER= !:-,
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SITE STREET= i ,, }
04 S DAVIS RDt
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:::: SPOKANE G,I F`i 99216
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APPLICATION
PARCEL*= 27541-2906
PERMIT '..1,'E=:: RESIDENCE ADDITION .... LIVING Rt:;OI`i
PLATO- 00086 PLAT NAME= SWANSONS SUB
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BLOCK= s LOT= ,a � ZONE= SFR ;��, .ti .1. ,:} I •,1.....
AREA= 00000000 F : � r.., ..:: 1:- WIDTH= t 1 1 DEPTH= =i •-Y :.:. i": ; tra :::: 50
PHONE= 509 926 6526
STREET= 1804 S DAVIS RD
ADDRESS= SPOKANE WA 99216
CONTACT
NAME:::::: i.:)WI'dE::R FJH(.11`"1.E:: NUMBER::::
z:I._I:Ei...:j:I:NG SETBACKS: ,:'>': FRON.1..:::: E:X:I:,`.'>' i...EF.1..:::: ::r' RI:IYH.1..:::: I:::>:i:S RI:::AR=:: {::XI
p; .i;.:n.:. a,..a. .j,, i,..ji..p:.j;.:p:.j,..j;. ..ji h: j¢ Ai ii N )li )�i fii Pi ji• Hi •Si• •i¢ aiREVIEW INFORMATION
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DEPARTMENT NAME
REVIEW {_, t.1 i'I (" I I::. I `•. , ..: !N/OUT INITIALS
--------------- ------------------ .................... — .......................... ----
1:St.1IL>.'ING & .\AF'I::..T.Y PLAN REVIEW REQU..1''•'.I::.1? 880219 Gi'i,,I
Bt.iIL..D.,.1'.i:G :.: SAFETY F.::NEF'!k:Y PLAN REVIEW F',E(}U:i:RED 88009 t: Iii
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ENVIRONMENTAL H:A.INCREASE IN ,1sCOVERAGE ':0. t } i .3
A (':1.I.1_; E:...1...i .1. 880219 t m h,(
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BUILDING E I : I t .. i '){ �•: )!i •)�: •)i• -)i• it• Pr )(. j;..p:.j?• $k :3i• •)�i •lei ')k :ii•'Ni :ti -Pr -li' 'll- •li- •Ih 7,r :?• .P:
CONTRACTOR=
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ADDITION= <: CHANGE OF USE::::
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SEWER= {''• HYDRANT= N
ENERGY CODE=
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UTILITY=
DESCRIPTION
GROUP ..i..YPE:.
SQ I::' ' (' VALUATION
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ITEM DESCRIPTION
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RESIDENTIAL VALUATION
STATE SURCHARGE
QUANTITY
.if i 1T I _.,,: AMOUNT'
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PERMIT
a+7.T T IFEE AMOUNT AMOUNT AiAMOUNT
FEB-19-'8R 12M7E1:HEALTH SP° TEL NO:509-456-4716 #n97 Pal , . ..........
FEB-19-'QE- 1115 ID:ELD5 AND SAFETY-!LFO TEL hi0:5Q -4 -473 1155 P01 --------
r'ROJr.CT NUMPrRw 0000020t;
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4i*444.kkkotvAat***,Ak4k*S440**0**44X4i.** APPLITION '0(.4(li44(Y44—itkiPOVIii“(**4t0tx:O.iii• iN4*
SUE STkUi-0, 11304 .')' DAVIS RP PAR f:r:1..,o, :;.•-‘!54.i ..2906
ADDREXS.,. &PORAIC WA 9902iA -
PERMTI USE,e; RLSIDENCh ADDITION - LIVING ROOM
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ADDRIi.E:a-..E EE;EFEOKANr WA 99;2,16
CON1AVF NAME- OWNV,k ,'4,10Nr.::: Ni
/MIMING SETPACIa• FKINT- rxiS IJ.r7.0, :7,2 RIGHIv rg;N: py:41R. Egt,s'
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DATI
DLPARTMEN1' NAMC aVILW CON6LNT;'..' YN/aa INTITALX
MUILDINC, & NAvFTY PLAN pEvlrw Jr i, IN)219 1-..MW
J FORRY 8F10219 GmW
ENVIkONMUNTAL HLALAH fNCKFA51,7 fN L ( LOW:RAF, Hil.'4029
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INFORMATION WORKSHEET
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PARCEL NUMBER: " ? 7 5 -y// -/ -- ' 4' 7 /z�4 ,
STREET ADDRESS: /7-04,7
CITY/STATE/ZIP: j� ✓ it , c -TiLa�, / • /
SUBDIVISION: �//`�'-y_,
BLOCK: / LOT: ZONE: DISTRICT:
LOT AREA: F/A: J WIDTH: ! / ../ DEPTH: /4422 R/W: 450
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: �y� /7 rz #r z�- � PHONE: 9/1e.;--„5-:07G;.
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MAILING ADISRESS: / 7 p La/ ��, ��.
CITY/STATE/ZIP:
CONTACT: PHONE: 57,,*
SETBACKS: - FRONT: `itS LEFT: 3'z RIGHT: REAR:
PERMIT USE: 1 'Si D -iJC'F- ADD - Lr'J'IJC% ROO)//
******************************************************************************
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE: - -
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: I
BUILDING DIMENSIONS: /'Z X 2,," (WIDTH X DEPTH) SQ. FT. : 2BB
REQUIRED PARKING: it HANDICAP: SEWER (Y/N) : HYDRANT:
. _ FEB-19- 88 1 _;1 'tltt n n !AU'otIP r .,.1
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