1999, 07-23 Permit Application: Adult Care to Level III Client UseProject Number: 99006675 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 7/23/99 Page 1 of 2
Project Information:
Permit Use: ADULT CARE HOME FOR 6 LEVEL III CLIENTS Contact: STAMPER, RUBY
Address: 3508 S ADAMS RI)
Setbacks: Front Left: Right: Rear: C - S - Z VERADALE, WA 99037
Phone: (509) 928-9093
Site Information:
Plat Key: 002748 Name: VERA District: F
Parcel Number: 45264.0122
SiteAddress: 2519 S ADAMS RD Owner: Name: STAMPER, RUBY
VERADALE, WA 99037 Address: 3508 5 ADAMS RD
Location:: VER VERADALE, WA 99037
Zoning: UR-3.5 Urban Residential 3.5
Water District: 010 VERA Hold: El
Area: 2.00 Acres Width: 316 Depth: 372 Right Of Way (ft): 40
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Department Review
BUILDING Plan Review
Comments:
Permits:
Contractor: OWNER
Address: 0
000000, 00 000000
Building Permit
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Const Category: Change Of Use
Nbr Of Dwellings: 1 Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: 0
Req Parking: Handicap Parking: Critical Materials: 0
This Application: Total Project:
Description Grp Type Notes Si Ft Valuation Sq Ft Valuation
RESIDENCE R-3 VN L.0 ADULT 0 $1.00 0 $1.00
CARE
LEVEL III
Item Description
CHANGE OF USE/SAFETY INSP
STATE SURCHARGE
Totals: 0 $1.00 0 $1.00
Units Unit Desc Fee Amount
1 Y OR BLANK $50.00
1 Y OR BLANK $4.50
Permit Total Fees: $54.50
ProjecF t Number: 99006675 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 7/23/99 Page 2 of 2
Operator: JDL Printed By: JDL Print Date: 7/23/99
Permit Type
Building Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$54.50 $54.50
$0.00 $54.50
$54.50 $54.50 $0.00 $54.50
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