2002, 11-08 Permit App: 02010048 AdditionProject Number: 02010048
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/8/2002 Page 1 of 2
Project Information:
.............................
.............................
.............................
Permit Use: RES ADD - MUD ROOM
Setbacks: Front Left:
Right: 15 Rear:
Site Information:
........................................................ .
Plat Key: 005835 Name: RIVERWALK 07TH ADD
Contact: BARCOMB, ANGIE & DAN
Address: 1710 N HOLLIDAY LN
C - S - Z: GREENACRES, WA 99016
Phone: (509) 891-1943
Group Name:
Project Name:
District:
G
Parcel Number: 55083.2407 Block: 4
SiteAddress: 1710 N HOLIDAY LN
GREENACRES, WA USA 990
Location:: GRE
Zoning: UR 3.5
Water District: 999 UNKNOWN
Lot: 7
Owner: Name: BARCOMB, ANGIE & DAN
Address: 1710 N HOLLIDAY LN
GREENACRES, WA 99016
Hold: ❑
Area: 0 Sq Ft Width: 65 Depth: 131 Right Of Way (ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Permits:
Contractor: OWNER
Building Permit
Firm: OWNER
Phone:
Building Characteristics
Const Category: Addition Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height:
Bldg W x D: x Building Sq Ft: Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials: ❑
This Application:
Description Grp Type Notes Sq Ft Valuation
RES ADD R-3 VN 64 $4,224.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Totals: 64 $4,224.00
Units Unit Desc
Operator: JAS Printed By: JAS
1
1
1
Y OR BLANK
Y OR BLANK
Y OR BLANK
Permit Total Fees:
Print Date:
Stories:
Total Project:
Sq Ft Valuation
64 $4,224.00
64 $4,224.00
Fee Amount
$100.50
$4.50
$22.11
$127.11
11/8/2002
Project Number: 02010048 Inv: 1
Application Date: 11/8/2002 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
OK TO ISSUE SEWER PERMITS PER ROGER 12/16/97
Permit Type
Building Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$127.11 $127.11
$0.00 $127.11
$127.11 $127.11 $0.00 $127.11
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 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: JAS Printed By: JAS
Print Date: 11/8/2002
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPOKE Com
SPECIFIC SITE INFORMATION
Street .Address:
/7 /0 It) hyoifda Al
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: add-otV Ma.d Roo, / Fi,t i5Ai't c SG(se wren
(i Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
Department Use Only
Water District/Purveyor.
Sewer District/Purveyor
Road width
Setbacks
Front Rear.
Left: Right.
School District:
Fire District:
- Zoning
OWNER/APPLICANT INFORMATION
0 Indicate who should be rontarted regarding this projeri
;RI
!� /
MAO
LAN 34 RCOfrt 13
l'hone 509-81/-/ 9 y 3
I ax:
❑ Applicant:
Phone:
I ax:
Mailing Address:
/710 N //01«ly
tA)
Mailing Address:
2nd floor sq. ft.
City, State, Zip
Green, acres kthok
990/6
City, State, Zip
Garage sq. ft.
❑ ContractorPhone
Fax
❑ Architect/ Engineer
Phone
Fax
Mailing address
Mailing address
City, State Zip
City, State Zip
WA State Contractor license #
Contact name:
PROTECT INFORMATION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
ft.
Unfinished basement F-1.
j. is00 /
Dimensions
Dimensions
8x
'Total habitable space
2nd floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
1 feat source (electric, gas, etc.)
Manufactured Home
Sign
Width:
Length:
What is thc square footage of the sign
face?
I low high is the sign?
Year:
Make:
# of signs
Arca of existing signs
,Are there slopes greater than 30% 0 on the property? (30 ft rise in 100 ft)
( %) 0 Ycs 14. No
Proposed use
Value
Relocation
Fire Safety
Firm Name
Previous address
Phone
Fire Sprinkler
fent
l'aint booth _ Fire Alarm
Fireworks display
Is there evidence of fill or excavation on the property?
13 Ycs 0 No
,Are there slopes greater than 30% 0 on the property? (30 ft rise in 100 ft)
( %) 0 Ycs 14. No
Proposed use
Value
• Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property? �/�
G7n,-, e
Phone
Will thc site be served by a septic system? O Ycs pt No
Plans Iixamincr
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
13 Ycs 0 No
,Are there slopes greater than 30% 0 on the property? (30 ft rise in 100 ft)
( %) 0 Ycs 14. No
.Are critical or hazardous materials used or stored on site?
0 Ycs i l No
Address
Inspector
Phone
O Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes O No
Ifyes, identify on site plan
What is the current property size?
(square feet or acres) j-.'/ 61000 S Q
Is any part of the property within 250 feet of a shoreline?
If yes, ident6' on site plan O Ycs 51 No
What is the current use of this property? �/�
G7n,-, e
Is your property in a designated wildlife habitat arca?
O Don't know O Ycs ffl No
Will thc site be served by a septic system? O Ycs pt No
Is any part of the property within a 100 yr flood plain?
Ifyes, identi, on site plan
O Maybe '11 Don't know O Ycs O No
Arc or will there be wells located on the property?
Ifyes, identify on the site plan A No
.Are there any wetlands, streams or ponds within 200 feet of the property?
Ifyes, identi.g on site plan 0 Ycs F, No
Is there evidence of fill or excavation on the property?
13 Ycs 0 No
,Are there slopes greater than 30% 0 on the property? (30 ft rise in 100 ft)
( %) 0 Ycs 14. No
.Are critical or hazardous materials used or stored on site?
0 Ycs i l No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
0 Ycs 0 No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA? 0 Yes 0 No
0 Yes 0 No
Is public water available to the site? 0 Yes 0 No
Is the property inside the PSSA? 0 Yes 0 No
Is the property located within 1000 feet of a Natural Resource Area?
O Yes 0 No
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ C.vsl i GI I Ck 0 mom 0 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
;CIE t
11\1'1.1:
I:X1'1RI :S:
BANKCARI)NUN1BI?R:
ALill 1ORI/.I?ll SIGNATURE:
SUBTOTAL
O'I :AI,
TOTAL FEE
MINIMUM PERMIT FEE IS $35.00PLEASE
MAKE Ci WECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER
DEC. -09-98 16 2131 -UN
6HUMbWOUU.numcm.A.
C-)\
"1 -hs n',n
representaton of the
lines/dimensions, ct.
have bee.7
bodes of Neter, ste
Signed:
Dale:
661
1 17 I D -F-Dt C1.0_,U;
sutrrited for thepurpose of
erm," and is a and correct
All known property
FtrUCture easements
natE3d ands,
s o., -;os or other ccal areas,
-0 2
2PG41\90\
LD 4- 71.1.2-,
1V-.vt-.Jo'LY
ADDRESS .‘_ri['0
ZONE
ROAD WIDTH 50
FRONT .2,9___FLANKING
COMMENTS ,
REVIEWED BV-._