2005, 09-07 Permit App: 05001359 ResidenceProject Number: 05001359 Inv: 2 Application Date: 09/07/2005 Page 1 of 3
THIS IS NIOT tP' ERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE - Contact: FOLSOM, TODD & ELEANOR
NATURAL GAS Address: 4015 S CONKLIN RD
C - S - Z: GREENACRES, WA 99016-9712
Setbacks: Front 22 Left: 22 Right: 5+ Rear: 24 Phone: (509) 928-6191
Group Name:
Site Information: Project Name: ROW
Plat Key: Name: BEVERLY HILLS 01ST ADD District: Sout
Parcel Number: 45193.0301 Block: Lot:
SiteAddress: 1012 S CENTER DR Owner: Name: FOLSOM, TODD & ELEANOR
Address: 4015 S CONKLIN RD
Location:: CSV GREENACRES, WA 99016-9712
Zoning: UR -3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 12,600 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Site Plan Review
iReleasedBy
Originally Released: 04/28/2005 By: KCUMMIN
Plan Review,,
Released By
Originally Released: 04/28/2005 By: TMELBOU
Approach /Drainage Released By ' TK�
Originally Released: 04/28/2005 By: KCUMMIN
Sewer Review
Released,B
Y.,.
05002608
Originally Released: 04/28/2005, By: KCUMMIN
Operator: K C Printed By: CJJ Print Date: 09/07/2005
Project Number: 05001359 Inv: 2 Application Date: 09/07/2005
THIS IS NOT A'PERMIT
Penalties will be assessed for commencing work without a permit
Permits: _-
Approach
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Building Characteristics
Group: R-3 Type: VB
Total Area 2325
Building Height 28
Stories 1
Dwelling Units 1
RESIDENCE R-3 VB
Item Description
RESIDENTIAL PERMIT FEE
STATESURCHARGE
RESIDENTIAL PLAN REVIEW
Contractor: OWNER
Contractor: OWNER
1,061 $79,235.48
Totals:
569 $9,663.00
3,794 $200,394.00
Units
This Application:
Total Project:
Description
Grp
Type
Notes
Sg Ft Valuation
Sq Ft
Valuation
2ND FLOOR
R-3
VB
Permit Total Fees:
$47.90
1,264
$94,395.52
BASEMENT U
R-3.
VB
PER T.
287 $4,305.00
287
$4,305.00
MELBOUR
NE
GARAGE
U-1
VB
900
$17,100.00
GARAGE
U-1
VB
PER T.
282 $5,358.00
282
$5,358.00
MELB OUR
NE
RESIDENCE R-3 VB
Item Description
RESIDENTIAL PERMIT FEE
STATESURCHARGE
RESIDENTIAL PLAN REVIEW
Contractor: OWNER
Contractor: OWNER
1,061 $79,235.48
Totals:
569 $9,663.00
3,794 $200,394.00
Units
Unit Desc
Fee Amount
1
SELECT
$31.00
1
SELECT
$4.50
1
SELECT
$12.40
Permit Total Fees:
$47.90
Mechanical Permit
Firm: OWNER
Phone: (000)000-0000
Plumbing Permit
Firm: OWNER
Phone: (000)000-0000
Operator: K C Printed By: CJJ Print Date: 09/07/2005
Page 2 of 3
Project Number: 05001359 Inv: 2 Application Date: 09/07/2005 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
LOTS 12 & 16 BLOCK 6 HAVE SPECIAL DRAINAGE REQUIREMENTS PLEASE REFER TO
ENGINEERS
CONTOL AREA FOR DRAINAGE MORITORIUM SEE MAPS FOR SPECIFICS
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $47.90 $47.90 $0.00 $47.90
$47.90 $47.90 $0.00 $47.90
1T_•_ _1 _'___ ----
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to. be 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: K_C Printed By: CJJ Print Date: 09/07/2005