1991, 01-16 Permit: 90003117 Residence SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 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 te or cal law regulating construction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION // �y
OWNER OR AGENT Al/ DATE / —/LOl ` i
A7
PROJECT + „ " fI • = Y000611 ( DA :: 01 /16/91 PAGE= 01
ISSUED - _ :wit
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H AVE PARCEL4- 28541 -1513
ADDRESS= SPOKANE WA 9920 .
PFPraTT USE= RESIDENCE i 'i.r!A R i'•14?E
PLATO=
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PLAT Ni:aMi:..= GLEN .:,E Irx ACRES t....
BLOCK=ft::::: {,•i-.{ { r_:
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ZONE=NE= Av\I7uISf4 _ F
AREA= n: - nt ;:t ` �r : � WI -I
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OWNER=,N,v.,••:.... ,,•+ PHONE= 509 92A 5229 ..
STREET= I'i'i 1fi, 13717
CONTACT 'h "{ _ hECROSBY ._.. PHONE ' t ' s {_ r
5229
BUILDING SETBACKS : FRONT= ri• • I - . REAR= . ,
ti iR•'hr*•At*•R'1>.•'A-*•iti* i*•A••A•3t:•1{'Pr*•R•A•-P.•*1t•-A••;`r-!!r in:::!;* BUILDING p I:::1"'M•I:1 ..•P;*.rJt..i'•.•.i...•J!:: : A*:*'P:-!k 3k {• •±!:a:J!i A^i*Jt1 1n.•11?•
CONTRACTOR= :... , r I•I': N1::. 509 926 tom,;;•
STREET= ..: i i BOX 13717
NEW= aREMODEL=
o" . ?EL : ADDITION= CHANGE OF
.
.
DWELL STORIES=
UNITS= i
_•-:'•- , PARKING= 41:HANDICAP= r'. T {•:I:C(i... MAT= N
�•• ... ice= ...
DESCRIPTION GROUP TYPE
SQ FT VALUATION
BASEMENT ,. P-3 1222 .10998.00
„r,
GARAGE j'j.._1 VN 484 :3388.00
1222 53768.00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
00
RESIDENTIAL VALUATION _
STATE SURCHARGE i 4 .50
COUNTY SURCHARGE. Y 80 .00
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CONTRACTOR= H D INC [ .. 5229
-`i t.
STREET= P 0 BOX 13717
ADDRESS- , ,ti - ;tWA 99213
ITEM .SC.R,.P.....,.O-N QUANTITY FEE AMOUNT
GAS WATER HEATER I ?{ l • i0
GAS .G .tl - ' ' 'r , $L ! }tni { . •; : :;
... .:+.
GAS PIPING 3 sf).,0,J
G fAi i` LOG i 10.00
.. .... ....:•.:•.:•.:•.:::t:•....:-.:-.-:*r(: r P:* ,;3'•i!;•i!i**$r 'i...U t"t:c .I.N C F:E Y+:1'1.I. i .li:::P::Ji::J(:1:..:j..}f!.J.....i�,.ij.. ...ii•ger:i' : i!!:itr*'Pr•;§Nr i!S:•i+r'hr-;t:•P:
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CONTRACTOR= C H D INC PHONE— 509 926 E=9
STREET= P 0 BOX 13717
ADDRESS- SPOKANE Wt; 99213
IT,....; DESCRIPTION QUANTITY FEE AMOUNT
..t.
TOILETS -) 12.00
SHOWERS 1 .f.:i0
BATH
I�::1:-(�t::I"IE::1,1 l:{dl{;A> � 6„00:its
DISH WASHERS
CLOTHES WASHER 1
6.00
_ _ _ ..,a_
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 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 OF APPLICATION
OWNER OR AGENT DATE
_,;.1, ,._ :,, PAGE •• V2
I'I-.#?:=::.t: ! !s±±!"!(:it:.Z#::: Jcti}..... i S ;` 11 PERMIT
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P s r "FJT DATE •! _ I PT PAYMENT { MOliif
:, :: ,r9 2;. 36 7 3 ... ..
.... .".,.,.. . F AMOUNT :`•MOU;;i"i' PAID AMOUNT OW l NG
BUILDING F:is RMTT 5 i4 ,`jo :8•4 °: o 0
} . .... - PERM,..1 x: ;, 00 54:.0 ..00
50
6 7 i..50 :.00
y.., TED B Y ' .L ORIA
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SPECIAL CONDITION CHECKLIST
Project
Address: Project# Use:
Dept: Date: Condition:
Init. Appr:
— — (m) (out)
Dept.of Bldgs. — -- -- — ---
------ — Special Insp.Final Report
— — -- -- — Hydrant( )
— -- Lock Box
•
Engineer's-_— RID/CRP
Easements
— --- _ Road Plans/Improvements
— Bonds
•
PlanningBonds
•
Utilities__ Double Plumbing
— — — ULID
Other --— --
' ` — —"`"..;""THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY"------
Date
NLY""""""'°Date received for C/O processing: —_ __ Plans pulled for final processing: _
Temporary 0/0 issued:___—_ __ —..Certificate of Occupancy issued: _
Office file review by: _ . Date:_ --__—_ — — —
Filed insp finaled by: . Date:.
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: __ --_—_-- Date:— _
Plans returned: .__---____ — . Received b
No response from owner/contractor-plans destroyed:_ --
t