1991, 04-02 Permit App: 91001543 Safety Inspect ' w�
SPOKAN :OUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOI(ANE,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 correctand athorize SkCounty to proceed with processing. In addition, have read and understandmo /wupsormwnsuumewswTmwor/os
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 canc 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 , 7,/,bizy/9/'
OWNER OR AGENT NW ieli-a0g DATE
PROJECT NUMBER= 9i OOi 543 APPLICATION DATE= O4/O2/9i PAGE= Oi
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
--------------------------------------------------------------______________
SITE STREET= 14i00 E ROCKWELL AVE PARCEa= 02'7;42-4':::(:)7
ADDRE%�= %POKANE WA 992i6
- ERMIT USE �' - '�-'' IN%Pr"-- '•
PLAT4= 000080 PLAT NAME= UNKNOWN
BLOCK= LOT= ZONE= UR-3.5 DI%T4= F '
AREA= F/A= F WIDTH= DEPTH= R/W=
4 OF BLDG%= DWELL = i WATEk DIST =
OWNER= ROBINSON PENNIE PHONE= 5O9 927 8839
STREET= 14100 E ROCKWELL AVE
ADDRE%%= %POKANE WA 992i6
CONTACT NAME= PENNIE ROBINSON PHONE NUMBER= 509 927 8839
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
******************************* BUILDING PERMIT ****************************
CONTRACTOR= OWNER PHONE=
NEW= REMODEL= ADDITION= CHANGE OF U%E= X
DWELL UNITS= OCC;P LD= BLDG %TORIE%=
BLDG W X D FT= %PRINKLER=
REQ PARKING HANDICAP= CRITICAL MAT= N ''
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ----------
ATE •
%URCHAR�� Y 4.50
CHANGE 'OF U%E/ AFETY IN%P Y 50 .00
*** *********************** *** PAYMENT %UMmARY ********************** *****
PAYMENT DATE RECEIPT4 PAYMENT AMOUNT
04/02/91 175 54 .50
------------
TOTAL DUE= .00 TOTAL PAID= 54 .5O
`
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------ -------------
BUILDING PERMIT 54 . 50 54 .50 .00
------------- ------------ -------------
54.50 54.5O .00
PROCESSED BY : WENDEL, GLORIA
PRINTED BY : WENDEL, GLORIA
******************************** THANK YOU *********************************
` `
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SPECIAL CONDITION CHECKLIST
Project
Address: _ _ Project# ___ —Use:_
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
------ —_ Special Insp.Final Report
------ — Hydrant ( )
___ — Lock Box
Engineer's RID/CRP
Easements
__ Road Plans/Improvements
--- Bonds
Planning Bonds_ .._
Utilities Double Plumbing ____
_ ULID
_
Other.
***— ****._..,,...,,.*********THISSPACEFORCOMMERCIALPLANSTRACKING,CERTIFICATEOFOCCUPANCYONLY""'""""""'"""""""
Date received for C/O processing: _ Plans pulled for final processing;
Temporary C/O issued:. ___. Certificate of Occupancy issued:
Office file review by: Date:
Filed insp finaled by: Date:
Ninety days after C/O issuance:
Owner/contractor called regarding the return of plans: __ _________ Date:__________.________._._.__________ _.____.___._._.
Plans returned: ____ _----_ ._ .Received by: _.________________..
No response from owner/contractor-plans destroyed:__________
Spokane County
DEPARTIVtENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
.4..' STREET ADDRESS: M/ V ( ,,,Q'li.7,/ //
4v CITY/STATE/ZIP: )0442 /144 9;/;'
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: 10„2,2/Lid Abv5/ PHONE: ,.... 0.4_ --:,27-(6),g59
MAILING ADDRESS: /Tll/(/ f M(daiil/
ITY/STATE/ZIP: bWe A71 7,//
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
****************************************************************************
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:
BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT. :
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: