1986, 01-07 Permit App: 00860006 Duplex(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
JFiAUtU AtytAJ ANt rUM Ut 'MN I MtIN 1 HL UJC
Project Number
Owner's Name LAST FIRST MI
S6//y3 t: V.
Project Address (Street Name & Number) Zip
?ij/ 9 -- 02 I 1)141,6 E‘..2) ecia RT .,...5---kAile aiA. 99,2 o 6
Applicant
LCD/ /,,vd (Iv.
Address
,S. 7, 7 Art/es
City
C.) pokQ46,
State
OUasi
Zip
99'. ' .
Phone
(51)9) 9af ,)s��
_
Business Phone
( )
Contractor/AgentAddress
c)4o/f /�,vd a,,c:
, 7 / ares ,i'd
City
SPo764,f/e
State
()As//.
Zip
99ao6
Phone
(soy) 9,,,. a' -a_6-9,,i'
Contact
F U. SE,-fr' F
License Number (Required)
woc FL_ c: i
/69/ /
Business Phone
(.Soy) .92f -a -6-9-2
Architect/Engineer
Address
City
State
Zip
Phone
( 1
Contact
Business Phone
( )
Lender
Address
City
State I
II
Zip
Phone
Describe Work
Res.
Comm.
Subdivision/Plat Name/Short Plat Number /
60- d;A Coagr i4o/d1`,'o4/ / choxr P/427- e3 XV.7
Assessor Parcel Number
07.-071— a23 d 9
Lot
PAgee/ e,
Block
Plat Number
S'3 -a417
Pertinent File Numbers
Zone
Comp. Plan
Census Tract
Number of Dwelling Units
a
Number of Buildings
/
Lot Size (Sq. Ft./Acre)
Depth Cl( .j
-l61 -
Fronts�je
t4. i(
Front Setback I Left Setback t
3o ' ► L0
Right Setback
C)
Rear Setback
Additional Information
lDEPARTMENT USE
Square Footage
rnF = )764
v 6 = itna
'a)
(3fck = 320
Building Technician
J0 KS 0.
Dale
1- 7-86
Group
R- 3
Type
Yi\)
DEPARTMENTAL REVIEW
I certify that'l have examined this application and state that the information contained in it and submitted
by me or my agent is true, correct, legal, and binding.
Owner's Signature)ZP /./ � Date
-7-1,
Approved
Cond.rov
Approval
Hold
Xrn// ,�.�p.� /
Environmental Health Permit Number "' —0066
5, F,J
-fig
U
1101 College
Room 200 .e�,ryo 7 1-s �. 1- Ad -1-4-) J .
U 1 ..Jf )
(0ivfit
Planning/Zoning
N. 721 Jefferson
Permit Number//
% 2'
Engineers
N.811 Jefferson /WA -6 0 V
u
Utilities
N. 811 Jefferson
Plan Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/CritIcal Material/etc.)
Fast Track/Special Inspection Information
Project Representative
Phone
Address
I certify that'l have examined this application and state that the information contained in it and submitted
by me or my agent is true, correct, legal, and binding.
Owner's Signature)ZP /./ � Date
-7-1,
PARCEL NUMBER:
INFORMATION WORKSHEET
d7SVV- a309'
STREET ADDRESS:
-eft/9--,2/ 111445 F/ Et_ D
CITY/STATE/ZIP: %SAO/14ndE/ WA, 9101aPores 99.2/
SUBDIVISION: SNOA.rP%-W%-
8.2 -Ze17
Ageec.
BLOCK: LOT: •IC ' ZONE: DISTRICT:
AMMO )C
LOT AREA://4 607 F/A: EQRE ,WIDTH: DEPTH: R/W:
# OF BUILDINGS: / # OF DWELLINGS:_ WATER DISTRICT:WRTEg war- a.?
OWNER: iCe ✓i seep o PHONE: Alf, - 92e - %Z Sac,
MAILING ADDRESS: 4°-/oI'2 .26 T
CITY/STATE/ZIP: Sipa M14A16'/ (,till. 99 ip /o
CONTACT: ValGE SSE/AP
SETBACKS: - FRONT: rye* LEFT: /Q
PERMIT USE: Zs P4.,Eic
PHONE: £b9 _- .72-a,
RIGHT: /a 1 REAR: 7Q
****************************************************************************
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: CCbI ! 400LFLC //f0 D04 /bVy3/9D
CONTRACTOR: 4jeinem AID CO , PHONE: Se* - 92- /(0 a
MAILING ADDRESS: £-96/L - /At D,1Qr/A S0/re At /CD
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: X REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: 2 OCCUPANT LOAD: BUILDING HGT: STORIES: SSE
BUILDING DIMENSIONS: a yi X 7 p (WIDTH X DEPTH) SQ. FT.: /(gyp
REQUIRED PARKING: # HANDICAP: Q SEWER (Y/N):.fit HYDRANT: Y
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: S -F479-2./ /l%/%,SF/eLD
CITY/STATE/ZIP:506K,44E kW. 99ais- PARCEL NUMBER: 7.5-44/_ 2309
OWNER: F. V. S e1/4013MAILING ADDRESS: S- 90/4 -/dOrnJp fairE t/Ub
(Street)
PHONE NUMBER: 9.18.7.25re
5PoilsidE 992/2
(City/State) (Zip)
CONTRACTOR:
MAILING ADDRESS:
LICENSE NUMBER:
PHONE NUMBER:
(Street)
(City/State)
(Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU
UNLISTED GAS APPLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
z
4'
= AMOUNT
x$10.00
x 25.00
x 10.00
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
X 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
.24 o^
i( e
NOTE: MINIMUM PRM,iT FEE IS $35.00
SIGNATURE
S
lAloct 11
SUBTOTAL
$ 6842 -
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$9300
Tokane County Department of Building and Safety
1't Rrnw
ndnv venue Snokane. WA 99260 1509) 456-3675
PLUMBING PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: a ,Fs4h/9_ r%/ Mwtisn o
CITY/STATE/ZIP: S4A'gn1E,(J,4
OWNER: /4 d, SE//0/0
PARCEL NUMBER: d ~Je-441(-.2 .30 `3
.2A-/6eo o4t .
PHONE NUMBER: 9fl-%2.r'C - ri002E
MAILING ADDRESS : £- 9o/4 /,4/D,pp/p sore diet %5 c44 /E 99A/2.-
(Street)
9,Z/Z(Street) (City/State) (Zip)
CONTRACTOR:
MAILLUG ADDRES
LICENSE NUMBER:
PHONE NUMBER:
(Street)
(City/State) (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
NUMBER OF
FIXTURES
X EACH
FIXTURE
= AMOUNT
TOILETS
SINKS
SHOWERS
BATH TUBS
KITCHEN SINKS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
UTILITY SINKS
ELECTRIC WATER HEATERS
FLOOR DRAINS
FLOOR SINKS
BAR SINKS
ROOF DRAINS
LAWN SPRINKLER
SEWAGE EJECTOR
WATER SOFTENER
URINAL
DRINKING FOUNTAIN
4
Z-
i
x $6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
44 °-
�Z o_
/3.e_
/1„°.-.1-•
/. 6-2
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
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