2000, 10-05 Permit App: 00009038 Change of Use I 1 PROJECT APPLICATION WORK SHEET
ilkSPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260 1
2)0 SPOICll COUNTY 509-477-3675 _ �
Project Description: ����i�/t ' �� )2t' r7 � 1/ r��C X1,7 '(/Y--f�
'� e� TYPE OF ,PPLICATION ��' 2' a �'I"5 � q p
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O Building Permit O Change in Use O Grading p Manufactured Home Permit
O Relocation El Sign O Tenant (New/Change) --"i7=,Other
SPECIFIC SITE INFORMATION
4),c31,15 t
Street Address: �4,44 :x5( /3 s(0 q 2 7 ` I!1
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Assessor's Tax Parcel Number(s): CQ SSS\dlia- 1 r- J-)
Legal Description: (03 — (4-81
Department Use Only
\Fater District/Purteyor. Sewer District/Purveyor Road width Setbacks
Front: Rear.
School District: Fire District: 'Zoning
Left: Right:
OWNER/APPLICANT INFORMATION
lEJ Indicate who should be contacted regarding this project
CIOwner:. 2( c1 Phone: 7L 57C(7 ❑Applicant: Phone:
✓S�.L'(.Y-� (b� � ' Fax: Fax:
Mailing Address: Mailing Address:
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City,State,Zip City,State,Zip
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Contractor Phone El Architect/Engineer Phone
Fax Fax
Mailing address Mailing address
City,State Zip City,State Zip
WA State Contractor license# Contact name:
PROJECT INFORMATION
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t ng ri ormation
Main floor sq.ft. Unfinished basement sq.ft.
Building height to peak #of stories
Dimensions Total habitable space 2nd floor sq.ft. Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of project Heat source(electric,gas,etc.)
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In the event of a fire, or other emergency neccessitating the evacuation of the facilit , v
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bold indicated evacuation routes shall be utilized. In the event that the nearest eva •r d� r
P< >Ol route is blocked by fire or other serious or non-removable obstacle, the nearest . tete
route shall be utilized. All evacuees shall make every effort to assemble on the fac'
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front lawn as quickly as possible to be accounted for.
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