1991, 05-02 Permit: 91000704 Relocate ResidenceSPOKANE COUNTBPArAAiT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/applicatlon, 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 th'e 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.
OWSIGNER RE OF 4^^4 n VAP DATE APPLICATION
OWNER OR AGENT lVV/"`++'1111CCC iCCC f7 -Y L �l C
PRtJ„'E:.::T NUMBER= 910 70704 ISSUED PERMIT DATE= 05/02/94 PAGE=
*ikie•X)tii *i :k -X. ii'i(' i(' i('r('* ib 'PERMIT INFORMATION *******fl***************** :k'k
SITE STREET= 11016 E Vr''..L.EYWAY AVE PARCE 16'343-0459
ADDRESS=' SPOKANE WA 99206
PERMIT tJSE:..: RELOCATE RESIDENCE ON X ASF`il.NJ
"_ATb:= 001852 PLAT NAME= C:ii''I't1P?i't1NiTY(TE{.i...i='L2''NG'..i=a:?-3:oS
I:LOC:A LOT= Zf.Lh 1R-3,.5 DI"T-
AREA=- 00010290 F/A= P WIDTH= DEPTH=:"
OF n{L..DGE= i d DWELLINGS= 1 W'°''( -R DIST = MODERN
OWNER= KLEIN,E::iRRY D PFI^NE;:=: 509 57'5 4992
TRE.ET::. 1624 .f WARDSON RD
ADDRESS= SPOKANE WA 992i2
CONTACT NAME= JERRY KLEIN PHONE NUMBER== 509 22 74'4'0
IL..DI:NG ,SETBACKS: FRONT= UNKN LEFT= UNKN RIGHT= UNKN i..;;EA UNKN
;t0.' Sci(k'1'iti('9¢'************ itii'i('•ki4'ki( ii**
CONTRAC'T'OR:::: OWNER
NEW=: X REMODEL=
BLDG W X T.i == X SQ P..(
41'iAP*IDI CAP=
BUILDING PERMIT •C'i('il'i('i(il'ii'ii'*i('ir'!f **i('i('it'§t'i('ii•ai"H :i ii'if ik'u'ii'
PHONE=
ADDITION==
BLDG HGT:_
SPRINKLER= N
CRITICAL MAT=
nriANt:E f'1F I.1SF=:
STORIES=
N
DESCRIPTION GROUP :, rv-, ,.,'_t FT VALIt'ATION
BASEMEN' .! R-3 VN 1 i 1_ 10044.00
I:Err DESCRIPTION QUANTITY FEE AMOUNT
RESIDENTIAL 'VALUATION Y 126.00
STATE:: SURCHARGE i 4,50
COUNTY SURCHARGE 20.16
h it'iF')F'h'it'H'i('i('R'i("1('iY9i'1('Y(':('i("A'A'it'ititit'***
.k..*. RELOCATION >LPFlT irFifn.Ea
hd4 vk e E viii
CONTRACTOR OWNER PHONE=
PREVIOUS ADDRESS.
STREET= 20 N :WALNUT RD
r SPOKANE ,c,,., ,.,
Au 'F'tE';35= WA 5 , i.
*
(
ITEM DESCRIPTION QUANTITY FEE AMOUNT
RELOCATION INSPECTION Y 50,00
k a SUMMARY itititit ii.************"*** iit it ieirm:i('
ie if§£:x.rt.iei('ii'ieri:k if it ir'k i('ik it ii'ii'iik it PAYMENT S'L!1t-tit• il`i
PAYMENT DATE:.
05/02/91
02/25'91
TOTAL DUE =
PERMIT T Y r'' F::
BUILDING MIT
RELOCATION PRM'T'
RECE''PIv
2524
853
.00 IOTAL PAID:::
AMOUNT P'AIIJ
50.00
2/00.66
FEE AMOUNT
PRf'Ci_:SSED Bi: Jui 1E SHATTO
PRINTED FY. „JULIEE SHATTO
1 50 . rtrt
50.00
200.66
PAYMENT AMOUN"i.
1 50 66
50.00
200.66
AMO' NT OWING
,00
.00
...._
.00 040
44ie ik'A'it3"*ik#i"i(-ii:d{ic.g. ii..g..3*),*3*3*0 i(....g.)& : it'* THANK YOU iEii'******The ae i'i i(' ii' RiE iE •k** 3*
Project
Address:
Dept:
SPECIAL CONDITION CHECKLIST,
Dept. of Bldgs.
Date:
Engineer's
Plao,ning•
Utilities
Other
r •
Condition:
J
- Project # Use.
Special Insp. Final Report
Hydrant ( )
Lock Box
RID/CRP
Easements - •
Road Plans/Improvements_
Bonds
Bonds
Double Plumbing
ULID
Init:
(In)
t
Appr:
(out)
THIS SPACE FOR COMMERCIAL PLANS TRACKING; CERTIFICATE OF OCCUPANCY ONLY
Date received for C/O processing: Plafis pulled for final processing
Temporary CIO 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:
'Plaiis.returned _ A L
t.
k Date'
Received by
No response from owner/contractor - plans destroyed.