2002, 02-19 Permit App: 02000965 Change of OccupancyProject Number: 02000965 Inv: I Application Date: 2/19/02 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Permit Use: CHANGE OF OCCUPANCY TO LICENSED CARE Contact: HEATHER BERG _
FACILITY Address: 2617 S DAVIS RD
C - S - Z: SPOKANE, WA 99216
Setbacks: Front Left: Right: Rear: Phone: (509) 891-1386
Group Name:
Site Information:
Project Name:
Plat Key: 001705 Name: MOUNTAIN VIEW 4TH ADD District: F
Parcel Number: 45274.0137 Block: Lot:
SiteAddress: 2617 S DAVIS RD Owner: Name: BROWN, NANCY
SPOKANE, WA 99216 Address: 2617 S DAVIS RD
Location:: SPO SPOKANE, WA 99216
Zoning: UR 3.5
Water District: Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Plan Re w w 1 Released By- �n�
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Perm its: d,m
Building Permit
Contractor: OWNER Firm: OWNER
Address: 0 Phone: (000) 000-0000
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Building Characteristics
Const Category: Change Of Use Group: LC -1 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: ❑
Req Parking: Handicap Parking. Critical Materials: ❑
Item Description Units Unit Desc Fee Amount
CHANGE OF USE/SAFETY INSP 1 Y OR BLANK $50.00
STATE SURCHARGE 1 Y OR BLANK $4.50
Permit Total Fees: $54.50
Operator: CKF Printed By: CKF Print Date: 2/19/02
Project Number: 02000965 Inv: 1 Application Date: 2/19/02 Page 2 of 2 ,
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes: y
SEWER HOOKUPS AVAILABLE FOR ALL LOTS PER ROGER 11/30/94
(5) TOTAL CLIENTS - (4) LEVEL I & (1) LEVEL II. MUST MEET ALL CONDITIONS OF FIELD
INSPECTION.
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $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 contrued 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: 2/19/02
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