1990, 02-02 Permit: 90000353 Relocate ResidenceSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
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
OWNER OR AGENTAPPLI ! gQ � DATE CATION _ — D
PROJECT NUMBER= 90000353
Mt:I DO F.R ifT(i PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 1012 N LONG RD PARCEL.*= 48551-0404
ADDRESS= GREENACRES WA 99016
PERMIT USE= RELOCATE RESIDENCE ON CRAWL SPACE
PLAT= 001764 PLAT NAME= NORDHAGEN'S SUB
BLOCK=
LOT= 4 ZONE= AGRI DISTI= C:
AREA= F/A= F WIDTH= 85 DEPTH= 120 R/W=
OF BLDGS= DWELLINGS= 1
OWNER= JENSEN MARK R
STREET= 13307 E 14TH AVE
ADDRESS= SPOKANE WA 99216
PHONE= 509 926 7124
CONTACT NAME= OWNER PHONE NUMBER=
BUILDING SETBACKS: FRONT= 57 LEFT= 15 RIGHT= 13 REAR= 63
******************************* BUILDING PERMIT ****************************
CONTRACTOR= OWNER PHONE=
NEW= X REMODEL= ADDITION= CHANGE OF USE=
DWELL UNITS= OCCIJP. LD= BLDG HGT= STORIES=
BLDG W X D = X SQ FT= 408
REQ PARKING= IHANDICAP-= SEWER= N HYDRANT= N
DESCRIPTION GROUP TYPE SQ FT VAI...IJATION
FOUNDATION R-3 VN 108 216.00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION r..__. Y_...._._.. 20.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 3.20
******************************* RELOCATION PERMIT **************************
CONTRACTOR= OWNER
PREVIOUS ADDRESS:
STREET= 1221 N PINES RD
ADDRESS= SPOKANE WA 99206
ITEM DESCRIPTION
RELOCATION INSPECTION
PHONE=
QUANTITY FEE AMOUNT
Y 50.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPTI PAYMENT AMOUNT
02/02/90 540 77.70
TOTAL DUE= .00 TOTAL PAID= ......_._--�--77.70
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 27.70
RELOCATION PRMT 50.00
77.70
PROCESSED BY: WENDEL, GLORIA
PRINTED BY: JUI...IE SHATTO
27.70
.000
77.70 .00
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