1993, 08-06 Permit App 93006759 Garage, Mud RoomPROJECT NUMBER= 93006759 APPLICATION'
DATE= 08/06/93 PAGE= 01
******
THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 17709 E INDIANA AVE PARCEL#= 55073.0928
ADDRESS= GREENACRES WA 99016
PERMIT USE= ATTACHED GARAGE & MUD ROOM
PLAT#= 002044
BLOCK=
AREA=
# OF BLDGS=
PLAT NAME= PLAT"A" GREENACRES IRR.DISTRIC
LOT= ZONE= UR-3.5 DIST#= G
F/A= A WIDTH= 152 DEPTH= 660 R/W= 40
# DWELLINGS= 1 WATER DIST = CONSOLIDATED IRRG #1
OWNER= LADD, ROBERT & LAUREL
STREET= 9320 N MOUNTAIN VIEW LN
ADDRESS= SPOKANE WA 99218
CONTACT NAME= ROBERT OR LAUREL LADD
BUILDING SETBACKS: FRONT= EXIS LEFT= 100+
PHONE= 50a ntiti q_
PHONE NUMBER= 509 927 9254
RIGHT= 50+ REAR= 100+
****************************** REVIEW INFORMATION *****************************
DEPARTMENT
BUILDING
COMMENTS:
BUILDING
COMMENTS:
REVIEW REQUIREMENT
PLAN REVIE RE.JIRED
SETBACK EW RE UIRED
HEALTHDIST INCREASE IN LOT COVERAGE
COMMENTS:
S fTE Pc.At
.G
P/ ,'x-il e
******************************* BUILDING PERMIT *******************************
CONTRACTOR= OWNER
NEW= X
DWELL UNITS=
BLDG W X D =
REQ PARKING=
REMODEL=
1 OCCUP. LD=
24 X 36 SQ FT=
#HANDICAP=
PHONE=
ADDITION= CHANGE OF USE=
BLDG HGT= 8 STORIES=
864 SPRINKLER= N
CRITICAL MAT= N
DESCRIPTION GROUP TYPE SQ FT
GARAGE M-1 VN 576
RES ADD R-3 VN 288
VALUATION
4608.00
11808.00
PROJECT NUMBER= 93006759 APPLICATION DATE= 08/06/93
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egwv& o»S To Mobs LE Home
PAGE= 02
1
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION 'Y 180.00
STATE SURCHARGE Y 4.50
RESIDENTIAL SURCHARGE Y 32.40
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 216.90 .00 216.90
216.90
.00 216.90
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: BURRIS, ROBIN
******************************** THANK YOU ************************************
Department of Labor & Industries
Factory Assembled Structures Section
INSTRUCTIONS:
1. Complete all spaces to and including the box with the
2. They draw map on reverse side of WHITE copy only.
3. Submit completed permit and fee to the nearest office
4. Contact and schedule the inspection with the office in
within 15 days.
Owner last name
Address
.
Installer/Contractor/Dealer
rt
Address
first name
signature X in it.
listed on the back.
which you submitted the permit
Day time phone
(': )
ALTERATION PERMIT
Do not complete shaded areas
("Permit #
13429
Invoice it
Insignia #
•
Date
1)
City
,...1
Phone
( )
Check the appropriate boxes in section A and section I3.
A
Commercial Coach
Serial No.
ij Mobile Home
Serial No.
HUD No,
EjRecreational V, 1iicle or ❑ Park Trailer
Serial No.
Model No. or Plan Approval No.
Signature of applicant or authorized representative
i•...... ilh
epa tment use only
City
State ZIP
(Contractor's registration number
State ZlP+4
B L] Alteration Inspection (check appropriate boxes below)
'-' Air Conditioning/Heat Pump
Electrical
Electrical Appliances
Fire Safety
Gas Furnace
Gas Piping
Plumbing
Structural
Wood/Pellet Stove - -
PIan Review
RV Inspection
Re -Inspection- - - -
Technical Inspection
FEES
$75.00
Serial No.
Original Permit
No.
$70.00
$75.00
$50.00
$50.00/hr
Make check payable to: Dept. of Labor & Industries
FEES DUE $
Request APPROVED or ❑ Request DENIED because of Specific Violations Of Washington Rules And Regulations.
Violations Must Be Corrected And Reinspection Requested Within 10 Days For Recreational Vehicles And 20 Days For Mobile
Homes and Commercial Coaches of the notice of violation date. (This does not apply to technical inspections). It Is Unlawful To
Offer For Sale, Rent, or Lease Any Non -complying Mobile Home, Commercial Coach or Recreational Vehicle.
LJIncluded are forms required which must be completed and fees st:' . tied before re inspection.
(Date Arca office Inspector
Total pages
F622-012-000 a ttion permit 12/91 White -Olympia Grccn-Contract. Canary -Inspector Pink -Purchaser Goldenrod -Purchaser
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