1996, 03-21 Permit App: 96001580 AdditionPROJECT NUMBER= 96001580 APPLICATION DATE= 03/21/96 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 922 N PIERCE RD
ADDRESS= SPOKANE WA 99206
PERMIT USE= FAMILY ROOM ADDITION
PARCEL#`= 45162.1168
PLAT,#= 004012 PLAT NAME= SP -296
BLOCK= 11 LOT= 2 ZONE= UR -3.5 DIST#= F
AREA= 00000000 F/A= F WIDTH= 115 DEPTH= 345 R/W= 50
# OF BLDGS= 2 # DWELLINGS= 1 WATER DIST =
OWNER= HOLLEN, ROBERT & ANDRIA
STREET= 922 N PIERCE RD
ADDRESS= SPOKANE WA 99206
PHONE= 509 922 1596
CONTACT NAME= ROBERT OR ANDRIA HOLLEN PHONE NUMBER= 509 922 1596
BUILDING SETBACKS: FRONT= 57+ LEFT= EXIS RIGHT= 15 REAR= 50+
****************************** REVIEW INFORMATION *****************************
DEPARTMENT
REVIEW REQUIREMENT
BUILDING PLAN REVIEW REQUIRED
COMMENTS:
BUILDING SETBACK REVIEW REQUIRED
COMMENTS :
3 -21-c
RN/ go a
HEALTHDIST INCREASE IN LOT COVERAGE
COMMENTS:
******************************* BUILDING PERMIT *******************************
CONTRACTOR= OWNER
NEW=
DWELL UNITS=
BLDG W X D =
REQ PARKING=
REMODEL=
1 OCCUP. LD=
17 X 21 SQ FT=
#HANDICAP=
DESCRIPTION GROUP TYPE
RES ADD R-3 VN
PHONE=
ADDITION= X CHANGE OF USE=
BLDG HGT= 12 STORIES= 1
357 SPRINKLER= N
CRITICAL MAT= N
SQ FT
357
VALUATION
21063.00
PROJECT NUMBER= 96001580 APPLICATION DATE= 03/21/96 PAGE= 02
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION Y 269.00
STATE SURCHARGE Y 4.50
RESIDENTIAL SURCHARGE Y 59.18
******************************* MECHANICAL PERMIT *****************************
CONTRACTOR= OWNER PHONE=
ITEM DESCRIPTION
GAS LOG OR GAS INSERT
QUANTITY FEE AMOUNT
1 10.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 332.68 .00 332.68
MECHANICAL PRMT 10.00 .00 10.00
342.68
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: BURRIS, ROBIN
.00 342.68
******************************** THANK YOU ************************************
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APPLICATION INFORMATION
Legal description as it appears on the property deed
ASSESSOR'S tax parcel number?
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OWNERor OCCUPANT
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Phone
MaUir a idress, /") City, state
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Zip
Inspector district
Building
Building height
# of stories
Contractor
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Mailing address
Architect/Engineer
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Main floor area
'2nd floor area
Unfinished basement area
Finished basement area
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
Manufactured 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)
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
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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