1999, 02-10 Permit App: 99000965 Change of Use Project Number: 99000965 Inv: 1 • Application Date: 2/10/99 Page 1 of 1
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: CHANGE OF USE-RESIDENCE TO ADULT Contact: MARY JO SATTLER
FAMILY HOME Address: 6302 E 4TH
Setbacks:Front Left: Right: Rear: C-S-Z SPOKANE WA 99212
Phone: (509)536-6302
Site Information:
Plat Key: 000000 Name: UNKNOWN District: D
Parcel Number: 35242.1338
SiteAddress: 6310 E 4TH AVE Owner:Name: NORTHWEST SENIOR CARE
Spokane,WA USA 99212 Address: PO BOX 557
Location::SPO MILTON-FREEWATER OR 97
Zoning: UNKN Unknown
Water District: 999 1(NKNOWN Hold: El
Area: 0 Sq Fi Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
i?evieiv in formation:
Permits:
Bo tiding Per it
Contractor: OWNER Firm: t)WNER
Address: 0 Phone: (000)000-000n
000000,00 000000
Building Character istics
Const Category: Change Of Use
Nbr Of Dwellings: 1 Occupant Load: Building ght: Stories:
Bldg W x D: x Building Sq Ft: Sj alders:
Req Parking: Handicap Parking: Critical Materials: El
This Application: Total Project:
Description Type Notes Su Ft Valuation Su Ft Valuation
RESIDENCE LC VN LC OCCUP 0 $1.00 $1.00
Totals: 0 $1.00 () $1.00
Item Description Units Unit Desc Fee Amount
CHANGE OF USE/SAFETY INSP 1 Y OR BLAHK $50.00
STATE SURCHARGE 1 Y OR BLANK $4.50
Permit Tot 41 Fees: $54.50
Payment Summary:
Operator: JAS Printed By: JAS Print Date: 2/10/99
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $54.50 $54.50 $0.00 $54.50
$54.50 $54.50 $0.00 $54.50
Notes:
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