1994, 10-17 Permit App: 94010280 AdditionPROJECT NUMBER= 94010280
APPLICATION
DATE= 10/17/94
PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET=
ADDRESS=
PERMIT USE=
3001 S BOLIVAR RD
VERADALE WA 99037
PARCEL#= 45263.2502
RESIDENCE ADDITION - DINNING ROOM
PLAT#= 004378
BLOCK= 70
AREA=
# OF BLDGS= 1
PLAT NAME=
LOT=
F/A=
# DWELLINGS=
OWNER= DICKSON, RON
STREET= 3001 S BOLIVAR RD
ADDRESS= VERADALE WA 99037
EVERGREEN POINT ND ADD
2 ZONE= DIST#= F
F WIDTH= 85 DEPTH= 125 R/W= 50
1 WATER DIST = VERA
PHONE= 509 928 1751
CONTACT NAME= INTERIOR RENOVATIONS PHONE NUMBER= 509 467 7495
BUILDING SETBACKS: FRONT= 'LEFT= RIGHT= 'AWL. REAR= J 111 -
Xr �. (ifVV
****************************** REVIEW INFORMATION ********** *I************
DEPARTMENT
BUILDING
COMMENTS:
REVIEW REQUIREMENT
CONTRACTOR LICENSE REQUIRED
0. DZ.
BUILDING PLAN REVIEW REQUIRED
COMMENTS:
BUILDING SETBACK REVIEW REQUIRED
COMMENTS:
HEALTHDIST INCREASE IN LOT COVERAGE
COMMENTS:
zed
******************************* BUILDING PERMIT *******************************
CONTRACTOR=
STREET=
ADDRESS=
NEW=
DWELL UNITS=
BLDG W X D =
REQ PARKING=
INTERIOR RENOVATIONS
12630 W SUNNYVALE DR
NINE MILE FALLS WA 99026
REMODEL=
1 OCCUP. LD=
12 X 23 SQ FT=
#HANDICAP=
PHONE= 509 467 9176
ADDITION= X CHANGE OF USE=
BLDG HGT= 12 STORIES=
276 SPRINKLER= N
CRITICAL MAT= N
PROJECT NUMBER= 94010280 APPLICATION DATE= 10/17/94 PAGE= 02
DESCRIPTION GROUP TYPE SQ FT VALUATION
RES ADD R-3 VN 276 11592.00
ITEM DESCRIPTION
QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION Y 135.00
STATE SURCHARGE Y 4.50
RESIDENTIAL SURCHARGE Y 24.30
PERMIT TYPE
FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 163.80 .00 163.80
163.80
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: BURRIS, ROBIN
.00 163.80
******************************** THANK YOU ************************************
APPLICATION INFORMATION
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PERMIT USE eES 1 1 _,,r{ A ho i -1-i C7 1,,t --- bjl i i,\ (- - \
Building New_ Change of use
Add Remodel
Building height
Stories
Contractor
Dimensions
lax��
Total square footage
License
Main floor
Unfinished basement
Address
Second floor
Finished basement
Architect/Engineer
Garage
Decks, etc.
Value
Manufactured Home
Sign
Width:
Length:
Square footage
Height
Year:
Make:
Contractor
Contractor
License
License
Address
Address
City, state, zip
City, state, zip
Relocation
Fire Safety
Previous address
Fire Sprinkler Tent
Paint booth _ Fire Alarm
Fireworks display _
VALUE
Contractor
Contractor
License
License
Address
Address
City, state, zip
City, state, zip
Fuel Storage Tanks
(Circle one) Above -ground Underground
Swimming Pool
Contents
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Contractor
License
License
Address
Address
City, state, zip
City, state, zip
..... ,,,
DEPARTMENT OF LABOR AND INDUSTRIES
THIS CERTIFIES THAT THE PERSON NAMED HEREON IS REGISTERED AS PROVIDED BY LAW AS A
_ •
- -
• ' - • REGISTRATION NUMBER ' . ,
' EXPIRATION:DATE
,INTERR*137LN
06/15/95
- - :EFFFCT1'VE
DATF
I:16/15M
INTERIOR RENCvATIONS
12630 SUNNYVALE _DR
4NINE NILE FALLS WA
99026
STATE OF WASHINGTON
F625-052-000 3-92)
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