2003, 01-06 Permit App: 03000057 DuplexProject Number: 03000057 Inv: I Application Date: 1/6/2003 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information: .......... - ......... .......
. .... .......... .......
......... .................................
...........
Permit Use: DUPLEVATTACHED GARAGES - FORCED AIR Contact: J S KIRKLAND CO
GAS
Address: 4005 S BEST CT
C - S - Z: VERADALE WA 99037
Setbacks: Front 35 Left: 12 Right: 10 Rear: 35
Phone: (509) 891-8211
Group Name:
Site Information:
Project Name:
.... ............................................................ ................
..........
Plat Key: 005942 Name: VALLEY RIDGE PUD
District: F
Parcel Number: 45241.2011 Block: 2
Lot: 11
SiteAddress: 728 S JERSTAD LN
Owner: Name: GOOD SAMARITAN
VERADALE, WA USA 99037
Address: 17121 E 8TH AVE
Location:: VER
GREENACRES, WA 99016-8556
Zoning: UR -7 Urban Residential -7
Water District:
Hold: F1
Area: 15,915 Sq Ft Width: 0
Depth: 0 Right Of Way (ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: I
Review Information: ... .............. . ............................
.......
............................. ...... ............
Revi
Site'.
Plan Review
Approach / Drainage
SewerReW* w
0Zr 5T
:Released.............
Permits: ......
. ........ . . . . . ........................... ...
..................... .. ...........................
Operator: RMB Printed By: RMB Print Date: 1/6/2003
Project Number: 03000057 Inv: IApplication Date: 1/6/2003
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit — - -
Contractor: J S KIRKLAND CO Firm: J S KIRKLAND CO
Address: 4005 S BEST Phone: (509) 879-4356
VERADALE WA 99037
Building Characteristics
Const Category: New Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers:
Req Parking: Handicap Parking: Critical Materials: El
Description
Grp
Type Notes
DECK
R-3
VN
GARAGE
U-1
VN
RESIDENCE
R-3
VN
Item Description
RESIDENTIAL VALUATION
STATESURCHARGE
RESIDENTIAL SURCHARGE
Contractor: J S KIRKLAND CO
Address: 4005 S BEST
VERADALE WA 99037
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS
CLOTHES DRYER
RANGE
GAS LOG OR GAS INSERT
HOOD -TYPE II
Operator: RMB Printed By: RMB Print Date: 1/6/2003
Page 2 of 3
This Application:
Total Project:
SQ Ft Valuation
Su Ft Valuation
390 $3,053.70
390 $3,053.70
1,100 $13,200.00
1,100 $13,200.00
2,786 $183,876.00
2,786 $183,876.00
Totals:
4,276 $200,129.70
4,276 $200,129.70
Units
Unit Desc
Fee Amount
1
Y OR BLANK
$1,400.00
1
Y OR BLANK
$4.50
1
Y OR BLANK
$308.00
Permit Total Fees:
$1,712.50
Mechanical Permit
Firm: J S KIRKLAND CO
Phone: (509) 879-4356
Units
Unit Desc
Fee Amount
2
NUMBER OF
$20.00
2
NUMBER OF
$24.00
6
# OF UNITS
$6.00
2
NUMBER OF
$24.00
6
NUMBER OF
$60.00
2
NUMBER OF
$20.00
2
NUMBER OF
$20.00
2
NUMBER OF
$20.00
2
NUMBER OF
$20.00
Permit Total Fees:
$214.00
Operator: RMB Printed By: RMB Print Date: 1/6/2003
Page 2 of 3
s y
Project Number: 03000057 Inv: 1 Application Date: 1/6/2003
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: J S KIRKLAND CO
Address: 4005 S BEST
VERADALE WA 99037
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
WATER PIPING - DWV
WATER USING DEVICES
Notes:
Payment Summa
Plumbing Permit
Firm: J S KIRKLAND CO
Phone: (509) 879-4356
Units
Unit Desc
Fee Amount
4
NUMBER OF
$24.00
6
NUMBER OF
$36.00
2
NUMBER OF
$12.00
2
NUMBER OF
$12.00
2
NUMBER OF
$12.00
2
NUMBER OF
$12.00
2
NUMBER OF
$12.00
2
NUMBER OF
$12.00
6
NUMBER OF
$36.00
Permit Total Fees:
$168.00
Page 3 of 3
Permit Type
Fee Amount
Invoice Amount
Amount Paid
Amount Owing
Building Permit
$1,712.50
$1,712.50
$0.00
$1,712.50
Mechanical Permit
$214.00
$214.00
$0.00
$214.00
Plumbing Permit
$168.00
$168.00
$0.00
$168.00
$2,094.50
$2,094.50
$0.00
$2,094.50
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: RMB Printed By: RMB Print Date: 1/6/2003
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
[Assessor's
treet Address: � .. _,
'12-8 ZD.i - L-�-N
Tax Parcel Number(s):
Legal Description:
S El
cm0 N �.� -7� p� , � , i'.
Project Description: / /Jl—
Building Permit D Change in Use O Grading O Manufactured Home Permit
O Relocation O Sign O Tenant (New/Chanp-e) D Other
Mailinr. address
City, State Zip
WA State Contractor license jr
OWNER/APPLICANT
INFORMATION
ra ,_s . . ...
INFORMATION
wilding height f o peak
-.mac:: �exl.�T.z=sem= - __�w'"..3.#` .z;~".i... -.-� r"'y.�f }3.v-"`�.......r''F,'§`* s. .;��s.�.,�--� '' s-J..--�•. iti ,_
b of stories Main floors h.
I
iinensions�
�(
or 4
Unfinished basement sq. h.
1
Total habitable s ace
� : C9 �j
a
2° floor sq. h.
Finished buemrnt sq. h.
ccupancy group
Constntction type
a /� / ,
Gara e s h.
g 4 ti ��
Deck sq. h��
est of projec�
'}+•
Chi �
Fleas source (electric, gas, etc.)
�
'dSilt>�CtUEC�OU
u�
REM—
._ 4�'r
� 4,€L��a`'' M ��_�Si �•_�' f!da...N. _--,,•,y $:.`.
S1
Width:
Width:
Length:
What is the square footage of the sign How high is the sign?
face?
Year:
Make:
N of signs Area of existing signs
Address
Paint booth
Fire Alarm Fireworks display
ADDITIONAL SITE INFORMATION
Are there structures on the property? O YesNo
1 What's the current property size?
I es, identify ons lac
Plans Eramincr
Previous address
Firm Namc Phonc
Inspectors:
Fire Sprinkler Tent
Is your property in a designated wildlife habitat area?
Address
Paint booth
Fire Alarm Fireworks display
Proposed use
Are or will there be wells located on the property?
Value
Phone
ADDITIONAL SITE INFORMATION
Are there structures on the property? O YesNo
1 What's the current property size?
I es, identify ons lac
Plans Eramincr
0- - 10,r
Phonc
Firm Namc Phonc
Inspectors:
I kc l– �0-
Is your property in a designated wildlife habitat area?
Address
O Don't know O Yes XNo
Is any part of the property within a 100 yr flood pain?
Are or will there be wells located on the property?
Inspector
Phone
O Concrete
O Welding O Bolting O Reinforcement
Are there any wetlands, streams or ponds within 200 feet of the
Address
property?
ADDITIONAL SITE INFORMATION
Are there structures on the property? O YesNo
1 What's the current property size?
I es, identify ons lac
/
(square feet or acres)f 4' W0 S
Is any part of the property within 250 feet of a shoreline?
What is the current use of this property?
I es, identify on site plan O Yes No
I kc l– �0-
Is your property in a designated wildlife habitat area?
Will the site be served by a septic system? O Yes No
O Don't know O Yes XNo
Is any part of the property within a 100 yr flood pain?
Are or will there be wells located on the property?
If yes, identify on site plan
If yes, identify on the site plan O Yes No
O Maybe O Don't know O Yes No
Are there any wetlands, streams or ponds within 200 feet of the
Is there evidence of fill or excavation on the propert
property?
O Yes No
I es, identify on site plan O Yes No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
Are critical or hazardous materials used or stored o si e?
% O Yes t<No
O Yes No
Date
%IET -iOD OF PAYMENT
Representative:
DEPARTMENT IJSF ONl-Y
:1 CASH [I CHECK ❑ vtsA ❑ r � ❑
FAXED PERMITS WILL ONLY BE ACEPTED W1T]li PAYMENT OF A MAJOR CREDIT CARD
)ATF:
tANKCARD NUMBER:
tUTHORIZED S1GNATIJRF:
EXPIRES:
SUBTOTAL
POTAY. FEEE� ��'
- h77IQ,ti1UM Pf Fhfll-7[f 1,5 1;5 X,111 4lf.
.J.iAEa-,i-I It, G}iS P�I'Abt,L 7Y>1PV_6�Nt -
(f 71MYPi R�irT Y --Li : 11 F
ADDRESS
ZONE LAL
ROAD WIDTH 3
FRONTFLANKING
C0MIM"Z
REVIEWED B _ _
This site plan is being su mitted for the purpose of
obtaining a building per_
I and is a true and correct
representation of the pro sal. All known property
lines/dimensions, curb lin s, structures and easements
have been identified. Also 'ndicated are wetlands,
bodies of watgr, teep sl s r,oth r itical eas.
Signed:
Date:
12'
DNVL,
138.1'
LOT l l 9LD6-l(- 2
R, q4 E., WI Ma
Vhf F -IDC -7 pcutp(
84, 52'
Pit! VC -
1Z13S' TU -S -TI b L�j t
.. (LST)�-b LA-tj E
35'