1997, 12-19 Permit App: 97010895 Adult Family Home j
PROJECT NUMBER= 97010895 APPLICATION DATE= 12/19/97 PAGE= 01
PROJECT NUMBER= 97010895 .APPLICATION DATE= 12/19/97 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 10107 E 42ND CT PARCEL#= 45324 . 0916
ADDRESS= SPOKANE WA 99206
PERMIT USE=-ADULT FAMILY HOME FOR 6 LEVEL III CLIENTS —
PLAT#= 002089 PLAT NAME= PONDEROSA ACRES 6TH ADD
BLOCK= 1 LOT= ZONE= UNKN DIST#= F
AREA= 00000002 F/A= A WIDTH= DEPTH= R/W=
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= HICKS, DANA/DEGENSTEIN, CINDY PHONE= 509 928 5247
STREET= 10107 E 42ND CT
ADDRESS= SPOKANE WA 99206
CONTACT NAME= DEGENSTEIN, CINDY PHONE NUMBER= 509 928 5247
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
Sewoge system designed
for IL: J
HEALTHDIST 6 CLIE TS FOR ADULT CARErOD 6 /1/4./ /
COMMENTS : /A7 / 9 7 ;7—
******************************* 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
ADULT CARE LC VN 6000 . 00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
CHANGE OF USE/SAFETY INSP Y 50. 00
STATE SURCHARGE Y 4 .50
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
PROJECT NUMBER= 97010895 APPLICATION DATE= 12/19/97 PAGE= 02
******************************** THANK YOU ************************************