1996, 07-30 Permit App: 96006031 Roof Repair �1
#
PROJECT NUMBER= 96006031 APPLICATION DATE= 07/30/96 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 10609 E 9TH AVE PARCEL#= 45204.0107
ADDRESS= SPOKANE WA 99206
PERMIT USE= ROOF REPAIR (NO RE-ROOF)
PLAT#= 002704 PLAT NAME= UNIVERSITY PLACE
BLOCK= 1 LOT= 10 ZONE= UR-3.5 DIST#= F .
AREA= F/A= F WIDTH= DEPTH= R/W=
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= BLACK, THOMAS PHONE= 360 574 5258
,2 STREET= 13915 NW 10TH CT
NADDRESS= VANCOUVER WA 98685
// CONTACT NAME= JOHN CARIOS PHONE NUMBER= 509 926 8297
BUILDING SETBACKS: FRONT= EXIS LEFT= EXIS RIGHT= EXIS REAR= EXIS
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING FIELD INSPECTION REQUIRED • pAr a p i Pi
COMMENTS: ' 4 *,
******************************* BUILDING PERMIT *******************************
CONTRACTOR= OWNER PHONE=
NEW= REMODEL= X ADDITION= CHANGE OF USE=
DWELL UNITS= 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
ROOF REPR R-3 VN 204.00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION Y 35.00
STATE SURCHARGE Y 4.50
RESIDENTIAL SURCHARGE Y 7.70
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
PROJECT NUMBER= 96006031 APPLICATION DATE= 07/30/96 PAGE= 02
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING P. 1 IT 47.20 .00 47.20
()duct:1:ot_
7.20 47.20
PROCESSED BY: -OL FRAZIE'
PRINTED BY: CAR• -'• IER
******************************** THANK YOU ************************************
APPLICATION INFORMATION
' What is the JOB SITE address? ASSESSOR'S tax parcel number?
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Legal description as it appears on the property deed
OWNER or OCCUPANT Phone
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Mailing address City,state Zip
Who should we contact regardiry this project? Phone j
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g #of stories
Building height
Contractor 2ooFz Qi:v4 oiH\ Dimensions TOTAL SQUARE FOOTAGE
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WA State Contractor license# Main floor area Unfinished basement area
Mailing address 2nd floor area Finished basement area
Architect/Engineer Garage area Size of decks,etc.
What is the heat source? What is the cost of your project, • b
Manufactured Home' Sign
Width: Length: What is the square footage of How high is the sign?
the sign face?
Year: Make:
Installer Contractor
Wa State Contractor license# Wa State Contractor license#
Mailing address Mailing address
Relocation Fire Safety
Previous address Fire Sprinkler _ Tent _
Paint booth_ Fire Alarm _ Fireworks display _
VALUE
Contractor Contractor
WA State Contractor license# WA State Contractor license#
Mailing address Mailing address
rust SOrage .I cllliKS JWuEililluii•y r'uut
(Circle one) Above-ground Underground Size/gallons Private
Contents of tank(s) Size/gallons
Public/semi-private
Contractor Contractor
Wa State Contractor license# 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.
Site Plan
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`��0�� ,wriNCLUDE THE FOLLOWING: .\
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❑ All roadways, driveways & eas ents A IDUndergrou tilities
❑ Distances from center of roads, right o1 ways, 0 North arro
private roads & property lines 0 Septic tanks wells
0 All existing & proposed buildings
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