1996, 11-14 Permit App: 96010102 Change of Use PROJECT NUMBER= 96010102 APPLICATION DATE= '11/14/96 PAGE= 01
****** THIS IS NOT A PERMIT ****** / /S7
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
14
SITE STREET= 11601 E 12TH AVE PARCEL#= 45214 . 1221 dpi Bo`l�
ADDRESS= SPOKANE WA 99206
PERMIT USE= LC CARE FOR MAXIMUM OCCUPANTS OF LEVEL 1 Xi/ BEDROOMS ONL
PLAT#= 000405 PLAT NAME= CLARK'S HILLCREST HOMES
BLOCK= 1 LOT= 1 ZONE= UR 3. 5 DIST#= F
AREA= 00000000 F/A= F WIDTH= 142 DEPTH= 130 R/W=
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= ARMSTRONG, NEMESIA PHONE= 509 926 0530
STREET= 11601 E 12TH AVE
ADDRESS= SPOKANE WA 99206
CONTACT NAME= NEMESIA ARMSTRONG PHONE NUMBER= 509 926 0530
BUILDING SETBACKS: FRONT= EXIS LEFT= EXIS RIGHT= EXIS REAR= EXIS
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING PLAN REVIEW REQUIRED
APPROVAL: J LARSON DATE: 11/14/96
HEALTHDIST L C OCCUPANTS
Some@ system designed
COMMENTS: for 3 bedmo ns oar. (9X .3 //—/V--?C.
******************************* BUILDING PERMIT *******************************
CONTRACTOR= OWNER PHONE=
NEW= REMODEL= 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
RESIDENCE LC VN . 00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
STATE SURCHARGE Y 4 .50
CHANGE OF USE/SAFETY INSP Y 50. 00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
PROJECT NUMBER= 96010102 APPLICATION DATE= 11/14/96 PAGE= 02
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 54 .50 . 00 54 .50
54 .50 .00 54 .50
PROCESSED BY: JOHN LARSON
PRINTED BY: JOHN LARSON
******************************** THANK YOU ************************************