2002, 04-05 Permit App: 02002303 Change of Use•
Project Number. 02002303 Inv: 1
Application
Date: 4/5/2002 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Ussc' CHANGE OF USE FROM RESIDENCE TO Contact. CHURCHILL, TAMMY
LICENSED CARE FACILITY Address. 2321 S BEST RD
C - S - Z VERADALE, WA 99037
Setbacks: Front Lefl: Right: Rear Phone (509) 927-0082
Group Name
Site Information: Project Name:
Plat Key: 000668 Name' EARLY DAWN 1ST ADD District:
Parcel Number 45262.2011
Block. Lot:
SiteAddress. 2321 S BEST RD
VERADALE, WA 991137
Location.. VER
Zoning: UR -3.5
Water District.
Area: 0 Sq Ft
Urban Residential 3.5
Width. 0
Nbr of Bldgs. 0 Nbr of Dwellings: 1
Review Information:
Ovaier. Name: CHURCHILL, TAMMY
Address- 2321 S BEST RD
VERADALE, WA 99037
Hold ❑
Depth 0 Right Of Way (ft) 40
Review
Plan Review
Permits:
Contractor OWNER
Building Permit
First. OWNER
Phone.
Building Characteristics
Const Category: Change Of Use Group: LC -1 Type VN
Nbr Of Dwellings: Occupant Load: Building Height:
Bldg \V x D s Building Sq Ft: Sprinklers
Req Parking: Handicap Parking: Critical Materials ❑
Item Description
CHANGE OF USE/SAFETY INSP
STATE SURCHARGE
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
Operator. RMB Printed By: RMB
Stories:
Fee Amount
$50.0(1
$4.5(1
Permit Total Fees: $54.50
Print Dale 4/5/2002
Project Number 02002303 Inv I
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/5/2002
Payment Summary:
Permit Type
Building Permit
Fee Atnount Invoice Amount
$54.50 $54.50
$54.50 $54.50
Amount Paid
$0 00
Amount Owing
$54.50
$0 00 $54.50
Page 2 of 2
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to he true and correct, and agrees that all provisions of laws and/or regulations governing this type of ssork ss ill he
complied with. Subsequent issuance of a permit shall not he cont rued to he a permit for, or an approval of, any violation of any of the
provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator. RMB Printed By RMB
Print Date: 4/5/2002
PROJECT APPLICATION WORK SHEET
SPOKANE COUNT'' DIVISION Or BUILDING & CODE ENFORCENI
1026 \X'E.ST BROr\DWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: 22 s ' ROM 1,
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description:
eci3fLv�
O Building Permit
O Change in Use
0 Grading
0 Manufactured Horne Perini(
O Relocation
O Sign
L Tenant (New/Change)
Ci Cflher
Department Use Only , ' .
Water District/Punemr.
Sewer District/Purveyor
'
Road width
Setbacks - -
From .Rear.
Left Right:
School District
Fire District:
Zoning
OWNER/APPLICANT INFORMATION
El India,* aim) .hp„ arbe .»n,,ared rrwrrkr._ rbi. pnynr
fl tanner.
�1'S•NrY'1ly (,�C LX/L( t I
Phone. 92_1- C 07-z_
I .i.:
1 ;\(,plicant.
nladigg • ddres--
Phone.
�i�"C,..� Fns
Marling :\Jdre..: �
2.-2.. t 3e�1/4--
c:in. }tato-. Ziff
sz,radat-e., c__OA
q0Z--1
(:et, Stair, Zip
Finished basement sq. fl
0 Contractor
I'hnnc
1 :r.
LI :lrchitec4'I ng,+ncer-
Phone
Fac
Marling aJJr,ss
I Ica( suurrc (cl.-cerin. g.ts, etc.)
Mailing adJec•,
I:en, Slaw Zip
city, Sonic Zip
\1'A State Conuaen,r liecrxc x
(;..ntaer ...mot"
PROJECT INFORMATION
Building Information
I3uil,ing height ur leak
ti of storieS
Main flour sq. it.
Unfinished basement Al. 6.
Dimensions
Total habir:tblc since
2.'d floor sy. it.
Finished basement sq. fl
Occupancy group
Construction type
(:now •y. It.
Deet. AI. ti.
(:r,si of lrrriect
I Ica( suurrc (cl.-cerin. g.ts, etc.)
Nlanufacturecl l-Ionie
Sign _
Width-
I en tat h
\Crhat is the spare fog uge of the sign
Iced
I Inst high is the sign?
Vete
NIA,-
tt of sir is
\res of rusting signs
I ntpet int
Proposed use
Value
Staff Itrpresrm.nu
Relocation
Fire Safety
Non; Residential •Energy Code Compliance?
lits mu. address
I5 }'our property in a designated wildlife habitat arca?
0 Don't know 0 Ycs 0 No
fire Spnn1ler
Tent
Panic booth Fire Alarm
rucworks display
_
I ntpet int
Proposed use
Value
Staff Itrpresrm.nu
Special Inspections Required? •
\\ bat is the current property sve?
(sc1nare feet or acres)
Non; Residential •Energy Code Compliance?
nn,, Name
I5 }'our property in a designated wildlife habitat arca?
0 Don't know 0 Ycs 0 No
\\4l1 the sue be served by a septic systcnl? 0 Yes 0 No
Phone
Are or will there be wells located on the propcmY>
if jes, trlentefj on the me plan 0 Ycs 0 No
Plans EEzn°ne,
Phone
I ntpet int
Are cnncal or hazardous materials used or stored on site?
❑Yes 0 No
Dao Irtuncd
Staff Itrpresrm.nu
Address
Inspector
Phone
0 Concrete
0
Welding
0 Bolting
0
Reinforcement
-Address
ADDITIONAL SITE INFORMATION
Ate there structures on the property? 0 Yes 0 No
If ref, idnrttfy on free plan
\\ bat is the current property sve?
(sc1nare feet or acres)
Is any part of the property within 250 feet of a shoreline?
If in. bleu/1/4 on safe plan 0 Ycs 0 No
\`‘ That I\ the current use of teen property)
I5 }'our property in a designated wildlife habitat arca?
0 Don't know 0 Ycs 0 No
\\4l1 the sue be served by a septic systcnl? 0 Yes 0 No
I. auy part of the property widen a 100 yr flood plain?
/fin. iAenyy on free plan
0 \lavbe 0 Don't know 0 Yeo 0 No
Are or will there be wells located on the propcmY>
if jes, trlentefj on the me plan 0 Ycs 0 No
Are there any wetlands, streams or ponds within 200 feet of the property?
If yes, ifentefy on site plan 0 Yes 0 No
Is there evidence of fill or ewcavaoon on the pvhpern
0 Yc 0 No
.\re there slopes greater than 30°10 on the proper? (30 ft rise in 100 R)
(/°'°) ❑Ycs 0 No
Are cnncal or hazardous materials used or stored on site?
❑Yes 0 No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
0 Yes
0
No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA? 0 Yes
❑ Yes
0
❑
No
No
Is public water available to the site? 0 Ycs 0 Nn
Is the property inside the l'SSA? 0 Ycs
0
No
Is the property located within 1000 feet of a Natural Resource Arca?
0 Ycs ❑ No
Dao Irtuncd
Staff Itrpresrm.nu
PMETI IOD OF PAYMENT
❑ C.\si 1 ❑ (:I I O<
visa
❑EMEM❑
FAXED PERMITS WILL ONLY BE ACEPrED WITH PAYMENT OF A MAJOR CREDIT CARD
B.\IN; KC 5121) NU\IRI li_
.\U I 1 IUItI'LI I) SIGN \ 1 Ulth.
SUB l l) 1'51.
TOTAL FEE
MINIMUM PERMIT FFV 15 5.25 001'11. h1
\I use CIIll.l.< P \\ 51II I It 1 QY)K \\I.
r 5f\ 11 PI 10111 rl \ 11A
S
INEETIPG PIKE
ON 100
GAGE --- -
-EL-t-14 6uiSic-,1�-�
Et„T
ppb= ^,`. ,"LAN
MUST E KEPT
NO EGRESS FEQ,IWENT S
0 r
1ifEPEN r 5.7 SQUARE
EAR F
EE
T
MET G�EANG t4E1U-c•41
MEI CLEAR OPENIWtOTN, NCHS
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