1996, 08-26 Permit App: 96006984 Change of UsePROJECT NUMBER= 96006984 iPPLICCATION
DATE= 08/26/96 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 11503 E SUNVIEW CIR PARCEL#= 45281.1912
ADDRESS= SPOKANE WA 99206
E
PERMIT USE= CHANGE OF USE/REMODEL =RESIDENCE TO ADULT FAMILY HOME
PLATO= 000996 PLAT NAME= GLEN VIEW ACRES 2ND
BLOCK= 3 LOT= 12 ZONE= SFR DIST#= F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
#` OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= HARPER, EVA R
STREET= 11503 E SUNVIEW CIR
ADDRESS= SPOKANE WA 99206
CONTACT NAME= EVA HARPER
PHONE= 509 926 4765
PHONE NUMBER= 509 226 3047
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
***************************** REVIEW INFORMATION *****************************
DEPARTMENT
BUILDING
COMMENTS:
PLAN REVIEW REQUIRED
REVIEW REQUIREMENT
HEALTHDI N OR AD
COMMENTS
TIONAL WASTE 2TER
I
.a......
119'r
r****************************** BUILDING PERMIT *******************************
CONTRACTOR= OWNER
PHONE=
NEW= REMODEL= X ADDITION= CHANGE OF USE= X
DWELL UNITS= 1 OCCUP. LD= BLDG HGT= STORIES=
BLDG W X D = X SQ FT= SPRINKLER= N
REQ PARKING= #HANDICAP= CRITICAL MAT= N
DESCRIPTION GROUP TYPE SQ FT VALUATION
ADULT HOME LC VN 200.00
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION Y 35.00
STATE SURCHARGE Y 4.50
CHANGE OF USE/SAFETY INSP Y 50.00
RESIDENTIAL SURCHARGE Y 7.70
Ar
PROJECT NUMBER= 96006984 APPLICATION DATE= 08/26/96 PAGE= 02
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 97.20 .00 97.20
97.20
.00 97.20
************************************i******************************************
* PROJECT NOTE: TOPIC = CONDITIONS DEPT = BUILDING
***************************************-****************************************
LICENSED FOR MAXIMUM (5) LEVEL I CLIENTS
PROCESSED BY: JULIE SHATTO
PRINTED BY: JULIE SHATTO
******************************** THANK YOU ************************************
APPLICATION INFORMATION
What is the JOB SITE address? ASSESSOR'S tax parcel number?
IIS S tAzNO I EI,V Gg SIV Ki91\ ;wry 01.612'0 j 1 �(
Legal description as it appears on the property deed
OWNER or OCCUPANT
Phone
c-
SU9
�
/
PMR
i`� /
Mailing address City, sta
Zip
Who should we contact regarding this project?
UIQ
Phone
C 22(,= -3C 17 MP -4,C
What work is being done under this permit?
Contractor
Building height
Dimensions
# of stories
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Mailing address
Architect/Engineer
Main floor area
-2nd floor area
Unfinished basement area
Finished basement area
Garage area
Size of decks, etc.
What is the heat source?
Manufactured Home
Width:
Year:
Installer
Wa State Contractor license #
Mailing address
Relocation
Previous address
Length:
Make:
What is the cost of your project?
Sign
................
What is the square footage of
the sign face?
Contractor
Wa State Contractor license #
Mailing address
Fire Safety
Fire Sprinkler _
Paint booth Fire Alarm
w
0.
0
How high is the sign?
Tent
Fireworks display _
VALUE
Contractor
WA State Contractor license #
Mailing address
Contractor
WA State Contractor license #
Mailing address
Fuel Storage Tanks
Swimming Pool
(Circle one) Above -ground
Underground
Contents of tank(s)
Contractor
Size / gallons
Size / gallons
Private
Wa State Contractor license #
Contractor
Public/semi-private
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.
Pre -Final Date: /
CERTIFICATE OF OCCUPANCY
ELEASE REQUIREMENTS
District
Permit Number: ?6- / 9�y
`' / /�
-------- - ----- --
Occupant (if different from owner):
Building Address: //St
��
S✓n /,�,J c, � 9)-d6
/9/Z
Architect:
Contractor:
Legal Description:
ys'/,
Owner & Address:Plans
TJn ✓ c,r sPo
t, C ��6
%
Examiner: 1.--.) A6, S .
Building Inspector:
l� A p
e uJ
Group: �L
Land Use:
❑
Mechanical Inspector:
Occupancy
Construction Type: ✓/i%
Occupant Load: S L. C
C%e.,h
Plumbing Inspector:
Occupied as: 46 p_ i:04...7, /
6.✓,o✓ /4,,., a
plan pulled f940.
Special Inspection Agency:
Additional information: %
,--p./e/ �r" g foJ
❑Plumbing #
NREC Inspector:
y
/
4/00 I 6kse & / JPde / .7 /-P/7
Other:
a. -d c
r eieln,s h 7'& 4 / G/c r
t .0 ,/r
-r- .4,,-.i! / iL ,---ir �.s",/ z �L h
❑
Required Approvals
I l
Items Required �,vmpLeic/uur.c nt 'ti
Complete/Date Initial
a
-------- - ----- --
•
❑ Mechanical #
❑
❑Site plan pulled for file
❑
❑Mechanical #
❑
❑Landscape plan pulled for file
❑
❑Mechanical #
❑
❑Drainage plan pulled for file
❑
plan pulled f940.
/eA/
eE
❑Plumbing #
❑nH,er
119
❑Final inspection w/corrections
❑
❑Sprinkler/alarm #
❑
❑Demolition #
❑
❑Reinspection w/corrections
0
❑Other
❑
❑Unauthorized occupancy
(Initiate compliance)
❑
❑NREC final
❑
Approved for Temporary Certificate of Occupancy
Date: Reviewed by:
❑Special inspection final(s):
Compact/Concrete/Masonry/
Bolting/Welding/
❑
/�
--,s-e.€ „Apr
Fee:
Expiration Date:
❑Hydrants/knox box/lane
0
❑Landscaping/irrigation
0
Conditions
0208 drainage
❑
❑Engineer certification/208
❑
❑Parking/paving
0
❑ Accessibility
❑
❑Critical materials/containment
❑
Approved f r Certificate of Occupancy �.
Date:
❑Utilities
review
3 (JO/ �,.► •P /
Conditions
❑Fire District
❑
❑Health District
❑
❑Fast Track Certification
❑
❑Other
Release date:
T.C.O.:
C.O.:
Mail to:
iAi n e ,/
Copy to:
COMMENTS
CONSTRUCTION PLANS/ROUTING
Date
Date
Date
Active File
Field
90 Day Hold
Compliance
7
Washington Stan
DEPART MEN L OF
SOCA SERVIC�ESLTH
AGING AND ADULfSERVICES ADMINISTRATION
FIRE SAFETY EVACUATION PLAN
WAC 388-76-200(11)
[DATM-A . 2.3 I 11q5
T Adult Family Home shall have a posted plan for evacuation to safe areas in event of fire. Draw a diagram of the floor pl.
your home in the space proveded below. Indicate escape routes and designate where staff and residents should meet
Aside the residence. Indicate the location of fire extinguisher(s) and smoke detector(s).
INSTRUCTIONS: Provider/Resident Manager completes and posts in a conspicuous location.
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