2002, 01-30 Permit App: 02000577 DuplexProject Number: 02000577 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Perini) Use NEW DUPLEX W/ATTACHED GARAGES - GAS
Setbacks' Front 21) Left: 5 Right: 10 Rear. 21.
Site Information:
Plat Key: 005942 Name: VALLEY RIDGE (PUD) Distri S
Page 1 of 3
Contact GOOD SAMARITAN
Address' 17121 E 8TH AVE
C - S - Z. CREENACRES, WA 99016-8556
Phone: (509) 924-6161
Group Nano:
Project Name'
Parcel Number: 45241.2105 Block' 3
StteAddress: 713 S JERSTAD LN
VERADALE, WA USA 99037
Location:. VER
Zoning: UR -7
Water District:
Urban Residential -7
Lot: 5
Owner: NameGOOD SAMARITAN
Address: 17121 E 8TH AVE
CREENACRES, WA 99016-8556
Hold: E
Area- 11,172 Sq Ft Wichli 78 Depth. 113 Right Of Way (fl): 30
Nbr of Bldgs: 1 Nbr of Dwellings 1
Review Information:
Review
Site Plan Review
Plan Review
Released Bc
Released' Bv:•
Approach / Drainage
Released Bv.
/-2_31:402-
Sewer
-31-0,-
Sewer Review
Permits:
Operator: DNID
Printed Bs: DNID
Released f3V0K.
1150f oz_
Print Da le: 1/30/2002
Project Number: 02000577 Inv 1
Application
Dale: 1/30/2002 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor. .1 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: R-3 Type' VN
Nbr Of Dwellings. Occupant Load. Building Height: 17 Stories. 1
Bldg W x D: 77 a 77 Building Sq Ft' 2614 Sprinklers ❑
Req Parking. Handicap Parking. Critical Materials' ❑
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
DECK R-3 VN 526 53.871.36 526 $3,871 36
GARAGE U -I VN 1,100 $13200.00 1,100 $13.20000
RESIDENCE R-3 VN 2.614 5162.068.00 2,614 5162,068 00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
'Fot:rls: 4.240 5179.139 36 4.240 5179.13936
Units Unit Desc
1 Y OR BLANK
I Y OR BLANK
I Y OR BLANK
Fcc Amount
$1.295.00
54.50
$284 91)
Permit Total Fees: $1,584 40
A'leckanical Permit
Contractor: J S KIRKLAND CO Firm J S KIRKLAND CO
Address' 41105 S BEST Phone (509) 879-4356
VERADALE WA 99037
Item Description Units Unit Desc Fee Amount
DUCT SYSTEMS 2 NUMBER OF $20.00
GAS WATER HEATER 2 NUMBER OF $20.00
GAS APPLIANCE<=I00.000BTU 2 NUMBER OF $24 00
GAS PIPING 6 # OF UNITS $6.00
HEAT PUMP OR A/C 0-3 TONS 2 NUMBER OF $24 00
VENTILATING FANS 6 NUMBER OF 560.00
CLOTHES DRYER 2 NUMBER OF $20.00
RANGE 2 NUMBER OF $20 00
GAS LOG OR GAS INSERT 2 NUMBER OF $20.00
HOOD -TYPE II 2 NUMBER OF $20.00
Operator. DMD Printed By' DNID
Permit Total Fees: $234.00
Print Dale 1/30/2002
Project Number: 02000577 I m
I Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/30/2002 Page 3 of 3
Contractor: J S KIRKLAND CO
Address 41105 S BEST
VERADALE WA 99037
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
WATER PIPING - DWV
WATER USING DEVICES
Notes: - -.. ....
Payment Summary:
Permit Type
Budding Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Firer J S KIRKLAND CO
Phone: (5119) 879-4356
Units Unit Desc
4 NUMBER OF
6 NUMBER OF
2 NUMBER OF
2 NUMBER OF
2 NUMBER OF
2 NUMBER OF
2 NUMBER OF
2 NUMBER OF
6 NUMBER OF
Fec Amount
51,584.39
5234,00
5168.(111
Permit Total Fees:
lncotce Amount
$1,584 39
5234 00
$168.11(1
Fee Amount
524.011
536.00
$12.1111
51200
51200
$12.00
512 00
$12.00
536.00
Amount Paid
50.00
50.00
$0.00
$168.00
Amount Owing
$1.584 39
5234 00
5168011
$1,986.39 51.986 39
50.00 $1.986 39
Disclaimer:
Submittal of this application certifies the owner (or person(%) authorized by the ow ner) has both examined and finds the information
contained within to be true and correct, and agrees that alt provisions of laws and/or regulations governing this type of wu rl: will he
complied with. Subsequent issuance or a permit shall not be cnntrued to be a permit for, or an approval of, am violation of an) of the
provisions of the code or of any other state or local Eats or ordinances.
Signature:
Operator: DMD Printed Bv: DMD Print Date: 1/30/2002
466.
SPoiANn COUWY
Street Address:
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026, WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675 Oa -57 7
7f3SPEECIFIC SITE INFORMATION
�La)
OWNER/APPLICANT INFORMATION
Q Indicate who should he contacted rr.ardrn tors
8 irr0/K}
Mailing Address
Utz- et
City, Starz, Zip
of n ones
Dimension`
3ccupancv group
:ost of proj
Year.
Length:
Make:
What is the square footage of the sign
face?
/ of signs
How high is the sign?
Area of existing signs
Previous address
Proposed use
Value
Fuc Sprinkler _ '
Paint booth Fire Alarm
Tent
Fireworks display
0 Concrete 0 Welding 0 Bolting 0 Reinforcement
Are there structures on the property?
/f yes, identify on site plan
Is any part of the property within 250 feet of a shoreline?
lfyes, identify on sire plan 0 Yes No
Is your property in a designated wildlife habitat area?
0 Dont know D Yes No
is any part of the property within a 100 yr flood p am?
/fya, identify on site plan
0 Maybe 0 Don't know
ADDITIONAL SITE INFORMATION
0 Yes JNo What is the current property size?
(square feet or acres)
0 Yes No
Are there any wetlands, streams or ponds within 00 feet of the
property?
/fyc, idenr t on sire plan 0 Yes *No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
1 -.- 0 Yes'MIN
p
DEPARTMENT USE ONLY
1110o05c +
What is the curvut use of this ropertyt
WiiI the site be served by a septic system? 0 Yes )(No
Are or will there be wells looted on the (°
property?�,
lfyes, identify an the site plan 0 Yes /t No
Is there evidence of fill or excavation on the property?.
0 Yes XNo
Arc critical or hazardous materials used or stored ost e?
0 Yes No
Dnr Received:
Staff Rrpresemativr:
METHOD OF PAYMENT
Ahs'e Gatr.
CASH 0 CHECK
FAXED PERMITS 'WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
EXPIRES:
BANK CARD NUMBER:
n UlliORIZ ED SIGMA -MIRE.
N
N
This site plan is being submitte• • thepurpose of
obtaining a building permit and is a tru •d correct
representation of the proposal. All known pro
linesldimensions, curb lines. structures and easeme
have been identified. Also indicated are wetlands,
bodies of wat r st • si.peot i is I r
Signed:
Date.
,lRSTAD LN.
Rik) w
SITE PLAN — LOT 28
ireir"smL'imir
ADDRESS
ZONE
ROAD WIDTH
FRONT
COMMENTS
1
GENERAL LEGAL
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1311641-000
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