1986, 06-30 Permit: 00011883 ResidenceS|G�A-TORE3F
OWNER OR AGENT
JOB AFDRESS
4/1 a
108 S CREENACRES
RD
00011883
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[AKEVIEW/ BUILDERS
Building Code Fee $1.r
Energy Studies Surcharge $l'.
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108 S CREENACRES
RD
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ilBERTY LAKE WA
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9901(.;'
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COX` ROBERT A
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FEES:
$372.58
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NEWMAN LAKE WA
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99025
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509-226-0555
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1 AKEVB*164L5
COUNTER APP:
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195511603
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0999
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01+001 RESIDENCE W/
GARAGE
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100 S GREENACRES
RD
STRUCTURAL
Building Code Fee
Energy Studies Surcharge
BUILDING
Valuation; Curr 40732
1 of Floors 01 1 of Bedrooms 000
PRIMARY STRUCTURE:
Desc: DWELLING Group: R-3
Sg-Ft 970 Occupancy Load
SECONDARY STRUCTURES:
Desc: DWELLING Group: R-3
Sq -Ft Occupancy Loa
Desc: DWELLINCUB Group: R-3
Sq -Ft 970 Occupancy Load
Desc| GARAGE Group: M-1
Sq -Ft 484 Occupancy Load
APPLICATION
DATE
PROJECT#
��*I
0013174
DATE.
•`/30/
00011883
BUILDINC $356.00
Building Code Fee $1.r
Energy Studies Surcharge $l'.
FEES:
$372.58
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COUNTER APP:
,"N"MM:
~ATE.
TOTAL FEE
TOTAL FEE
TOTAL FEE
Permit Fee
# of Rooms 000
Type: VN
Rate 32.00
Type; VN
Rate 32.00
Type: VN
Rate 6.00
Type: VN
Rate 8.00
$1.50
$15,00
$356.00
356.00
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DEPARTMENTAL REVIEW
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent to compile said application is true and correct.
i n
S g ature
Date 6-4 /r6
Approved
Cond.
Approval
Hold
Environmental Health Application 1
'
5—/3'0°
Fikik
W. 1101 College
Room 200e
L,,,jil' "(//Y1/i/f
r/eej
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Planning/Zoning
N. 721 Jefferson
Engineers�iJ �`�
N. 811 Jefferson `,0 ''
s
/
Utilities
N. 811 Jefferson
I
Pian Review/Fire Prevention
N. 811 Jefferson
Ot3)44.
Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection Information
Protect Representative
Phone
Address
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent to compile said application is true and correct.
i n
S g ature
Date 6-4 /r6