1991, 03-22 Permit: 91001296 Repair Fire Damage Ill
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
1W. 1303 BROADWAY AVENUE
SPOKANE,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 correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the 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.
SIGNATURE OFAPPLICATION �� 2 f
OWNER OR AGENT
Al<4v/46--
DATE /
HROjEUI NUMBER= Y10012Y6 ISSUED a.:':. .,..,..I.{. .!,!••e : t:i.. %'.,..,,..":>%•j i-'AGE= 01
F? ?* ?H9dtR 999 i:i9k) 94 ti*9g19iPERMIT INF: ! " »T1tt •3?•3?'}!r**Sk*4?•9?•:R••!k•}?'i•`. F i?4?'9Y 9?9t.9t..j?.9:..j1.di.lt..P:H'Mr
SITE STREET= ? ..:Ey:,!:.; ±... 8TH 1'•t r••?t:?::. ;.:r..t I'f k.:?':.?...•t,•= 23544-0A04
ADDRESS= `/E:.RAD.r.:!?...E %4(: 9903 .
PERMIT USE= REPAIR FIRE DAMAGE
PLATO=.y..... ;,�.�3;' } PLAT? ±`j r•�t"?::.::.: VERA
r• t ,
};s#...j.ji..•t!,= LOT= ZONE= It±.,.. 3 . y DIST4= :
AREA= 00032000 p•/r•'.jF WIDTH= DEPTH= Ft:/i4: :: 45
4 OF i•• :f#...D l.r S__ :##: DWELLINGS= i WATER DIS1 -...
OWNER= RASSLOW, FRED PHONE= 509 928 1934
STREET= 12508 S MADISON RD
ADDRESS= VALLEYFORD WA 99036
CONTACT NAME=..... FRED
!t : 4? PHONE
' „ " NUMBER=
I " : ± ":
i1469
BUILDING SETBACKS : FRONT= NA ? . . T. '. RIGHT= NA REAR= NA
************************:k****** BU .td # 4r PERMIT ***********************x****
CONTRACTOR=
- - ?A: OF = { . 1GENERAL
vNE.AlCOu RA ., tRS , r : PHONE= ` % ?: : 0007STREET= 611 W CLEVELAND AVE
ADDRESS=S` S`.1-'OK.ANE WA 99205
NEW= . REMODEL:::: X ADDITION= CHANGE OF USE:::
?14+1::.!...1_. UNITS= 1 OCCUP, LD:::: BLDG j.'':::: STORIES=
BLDG W ._<. j = !_ SQ ;. I ,_ SPRINKLER= N
REQ. PARKING= 0HAND1CAP= CRITICAL MAT= N
DESCRIPTION GROUP
PI: tr? FT i U Ii;,
REMODEL R73 VN 'i 6!0 0..f;0
ITEM DESCRIPTION t,t U 1 FEE AMOUNT
RESIDENTIAL VALUATION Y € 1 :.t:0
STATE SURCHARGE 4.50
COUNTY SURCHARGE 27.36
a : : . nAra *! K P }* ?i : ; rlra ( [rr ?x k PAYMENT SUMMARY !19P } 4*Pi **.. k R .,:.j•:. 7 t {
PAYMENT DATE RECUIPT0 PAYMENT AMOUNT
03/22/91 1471 202.86
TOTAL? A#... !..•'1.i::.-... .00 TOTAL t''{si3;..:. 202,86
PERMIT i ? f.:?:: FEE AMOUNT AMOUNT e '`f? .D AMOUNT t..:x..t.1' G
#
BUILDING PERMIT 202.86 202; ,A ,00
202.86 202.86 .00
PROCESSED BY : jULIE SHATTO
PRINTED ED. a Y - jU1_IF moo#'•#A t ? ... .
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