1996, 07-18 Permit App 96005634 CarportPROJECT NUMBER= 96005634 APPLICATION DATE= 07/18/96 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 12508 E 4TH AVE PARCEL#= 45222.1423
ADDRESS= SPOKANE WA 99216
PERMIT USE= CARPORT 0T3RA�'L►"(24 X 20)
PLAT#= 004201 PLAT NAME= SP-460
BLOCK= LOT= 2 ZONE= UR-3.5 DIST#= F
AREA= 00000000 F/A= F WIDTH= 165 DEPTH= 102 R/W= 50
# OF BLDGS= 1 # DWELLINGS= 1 WATER DIST =
OWNER= DALE, ROBERT B
STREET= 12508 E 4TH AVE
ADDRESS= SPOKANE WA 99216
PHONE= 509 924 0963
CONTACT NAME= ROBERT DALE PHONE NUMBER= 509 924 0963
BUILDING SETBACKS: FRONT= 29 LEFT= NA RIGHT= NA REAR= NA
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING
COMMENTS:
L & I REVIEW
4
p e r 1 4 v hey, nouLA)..,
2 -/ e
BUILDING PLAN REVIEW REQUIRED
APPROVAL: J SHATTO
BUILDING SETBACK REVIEW REQUIRED
APPROVAL: J SHATTO
DATE: 07/18/96
DATE: 07/18/96
******************************* BUILDING PERMIT *******************************
CONTRACTOR= OWNER PHONE=
NEW=
DWELL UNITS=
BLDG W X D =
REQ PARKING=
REMODEL=
OCCUP. LD=
24 X 20 SQ FT=
#HANDICAP=
DESCRIPTION G
ADDITION= X CHANGE OF USE=
BLDG HGT= 8 STORIES= 1
480 SPRINKLER= N
CRITICAL MAT= N
ROUP TYPE SQ FT VALUATION
CARPORT U-1
VN 428 1926.00
PROJECT NUMBER= 96005634 APPLICATION DATE= 07/18/96 PAGE= 02
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION Y 64.75
STATE SURCHARGE Y 4.50
RESIDENTIAL SURCHARGE Y 14.25
PERMIT TYPE
BUILDING PERMIT
FEE AMOUNT AMOUNT PAID AMOUNT OWING
83.50 .00 83.50
83.50 .00 7 83.50
PROCESSED BY: JULIE SHATTO
PRINTED BY: JULIE SHATTO
******************************** THANK YOU ************************************
Department of Labor & Industries
Factory Assembled Structures Section
INSTRUCTIONS:
NON UNDA
1. Complete all spaces, including the signa ure box (marked with an X).
2. Draw a map on reverse side of WHITE copy only.
3. Forward completed permit and fee to th nearest L&I office. See list on reverse.
4. Contact and schedule the inspection with the same L&I office within 15 days.
Owner last name
first name
Day time phone
(i )
RATION PERMIT
Do not complete shaded areas
/Yermn
Date
Address City
State ZIP
Installer/Contractor/Dealer
Phone
( )
Contractor's registration number
Address
City
State ZIP+4
Check the appropriate boxes in section A and section B.
A ❑ Commercial Coach
Mobile Home
Se
HUD
Recreational Vehicle or ❑ Park Trailer
yen
Model No. "Plan AVM al No
FEES
B ❑ Alteration Inspection (check appropriate boxes below) $75.00
Air Conditioning/Heat Pu B
Electrical �'Aul o,=f+li OF AiuJR 8 INNS TRii S
(Signature of applicant or authorized representative
MOWN
Electrical Appliances
Fire Safety
Gas Furnace
Gas Piping
Plumbing
Structural
Wood/Pellet Stove — —
Plan Review
RV Inspection
Reinspection
Technical Inspection
JUL 181996
SPOKAl\k, WA
Original Permit
No.'k..
$70.00
$70.00
$50.00
$50.00/hr
Make check payable to: Dept. of Labor & Industries
FEES DUE $
Request approved or Requestdeniedbecause of specific violations of Washingtonrules arid regulation' Violations
must be corrected and reinspection requested within 10 days for •recreational vehicles and 20 days for mobile homes and
cnnimercial coaches of the nice of violation date. (This does not apply to technical inspections). • It is tiulawful to offer for sale,
rent, or lease any now:complying mobile home, commercial coach or recreational vehicle.
Included are forms.;
(Date
uired whichmustbe completed and fees submitted before remspection.
Area office
nspector
22-012-000 alteration permit 4-96
White -Olympia Green -Contractor
(Total pages).
Canary -Inspector Pink -Purchaser Goldenrod -Purchaser
APPLICATION INFORMATION
'\Nhat is the JOB SITE address? ASSESSOR'S tax parcel number?
/2 ,f 0 5 9/o /) v
Legal description as it appears on the property deed
OWNER or OCCUPANT
Phone
/2- .5l7 L-1/7 0 •. 5 f
Mailing address
A c) /3 '�'7 73 - L7 L
City, state
Zip
Who should we contact regarding this project?
t✓� ill—-- d r✓C /2 SL %
Phone
What work is being done under this permit?
co)
7
a
a,
Contractor
WA State Contractor license #
Building height
Dimensions
'2 / )4,
Main floor area
# of stories,
TOTAL SQUARE FOOTAGE
Unfinished basement area
Mailing address
2nd floor area
Finished basement area
Architect/Engineer
Garage area
8
Size of decks, etc.
What is the heat source?
viu
What is the cost o your project?
Manufactured Home:
Width:
Length:
What is the square footage of
the sign face?
How high is the sign?
Year:
Make:
Installer
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
Relocation
Previous address
Fire Safety
.............::............... .
................................
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
I
uel Storage Tanks;
swimming woos:
(Circle one) Above -ground Underground
Contents of tank(s)
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Contractor
Wa State Contractor license #
Mailing address
WA State Contractor license #
Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
Site Plan
}
a
1
7 J S
t _ _
he /�
r
Gy
To ).
INCLUDE THE FOLLOWING:
❑ All roadways, driveways & easments
❑ Distances from center of roads, right of ways,
private roads & property lines
O All existing & proposed buildings
❑ Underground utilities
❑ North arrow
O Septic tanks & wells