1991, 10-30 Permit App 91007374 MHSPOKANE 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
PROJECT NUMBER::_ 91 (07374 APPLICATION
DATE= 1 0/30/9'1 PAGE 01
•3•:**** THIS IS NOT A PERMIT *****
PENALTIES W:I:E..i... BE ASSESSED E::ii FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREeEt:•- T
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PERMIT U E:: -:,
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BLOCK=
AREA
It OF BL_ )GS:W
3504 N FLORA i'; D •F•'t~'1 R t.. t:: L. 4 - r?,.; = 5 ` ...' t i 5 9
SPOKANE WA 99214
MOBILE i'1C1MF: AS CARETAKER RESIDENCE
002041
00000003
PLAT 'NAME::; PLAT = OF WEST FARMS IRRIGATE
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LOT:::: ZONE ,I•._.r> I;T r''T':;::::: f;
f:',•'A=- F3 W I:I?TH= it.::P TH=: h li+i= 60
D1.4ELL...ING « 1 WATER DI,`.;'T ;: CONSOLIDATED TRRG 41
OWNI R::= CAMPBELL, , i._E::f3N;.tA
`rT F4E:.E:.T=:: 35O4 N FLORA Ri?
ADDRESS: Pfl ANE:: WA 99216
CONTACT T NAME= I•••E-' AtNNA1 C::AMPBEL...L
FnI..it:1NE= 509 924 0619
PHONE: iNfl• M EF:' = 509 924
BUILDING SETBACKS: FRONT= 540 LEFT= 'i 0 f RIGHT= 2. {..' t::,R::: “A
**•H3(**** ****3f3e*•K*N:*•h:**ii.**343i** RE::v:i:EW INFORMATION •3i•*••A*x.3ir:-***k .*.t,....*...j,:..*
DEPARTMENT REVIEW COMMENTS
BUILDING SETBACK BAc:i•:i REVIEW REQUIRED
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DLSCRIPTION
INSPECTION IC N FEE
STATE SURCHARGE
COUNTY SURCHARGE
PERMIT TYPE FEE AMOUNT
MOBILE l•-Io•iE: PMT 120.50
.120.50
PROCESSED BY: JOHN L.AR. ➢ON
PRINTED BY: JOHN L..ARSON
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OCT-31-'91 11:39 ID:HEALTH SPO
TEL NO:94982243
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TYPE OF SEWAGE SYSTEM.
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LINEAL OR SQUARE FOQ�GE;.
SURFACE TO BOTTOM
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O; AWE SYST.a
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SIGNATURE;
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TO. THIS APpRU • L«
AT (boa) 4t 6-6U401 PRIOR 10 ,l.,y'ALLAIIOS,
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Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
STREET ADDRESS:
CITY/STATE/ZIP: 3
SUBDIVISION:
BLOCK:
INFORMATION WORKSHEET
LOT:
•
ZONE: DISTRICT:
LOT AREA: F/A: A. WIDTH:
# OF BUILDINGS:
OWNER:
MAILING ADDRESS: /1 ,
# OF DWELLINGS:
CITY/STATE/ZIP: S r ?. /+'fig;(;;
` t1itt
DEPTH: R/W:
WATER DISTRICT: ((Lip
PHONE:
CONTACT: ';: i r 1vL PHONE:
e...
SETBACKS: — FRONT:S4iq LEFT:/op RIGHT: RZS REAR:/Ary'
t�
PERMIT USE: � 4' ; i:' f 3' a1'
****************************************************lkiirfe*aklkie******friefe*******
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
PHONE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
Please provide the following information for Energy Code compliance:
Space heating type (check one)
Forced air electric
Forced air gas
Flat ceilings R
Vaulted ceilings R
Above grade walls R
Below grade walls R
Floor R
Slab on grade R
Electric baseboard or wall mount Propane
Heat pump Other:
Doors U
Windows U
Glazing area %:
Total floor area
of heated space
Furnace efficiency rating
Please indicate on your plans: The location of the radon vent, and the location of the vent fan area.
Square footage
Main floor:
Second floor:
Basement — Finished:
Unfinished:
Garage:
Carport:
Decks:
Additional Areas: