2000, 07-12 Permit App: 00005877 RemodelProject Number: 00005877 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 07/12/2000 Page 1 of 2
Project Information:
Permit Use: CONVERT PORTION OF GARAGE INTO Contact: CHANDLER, BOB & KATHI
BEDROOM Address: 17109 E MONTGOMERY DR
C - S - Z: GREENACRES, WA 99016
Setbacks: Front Left: Right: Rear: Phone: (509) 000-0000
Group Name:
Site Information: Project Name:
Plat Key: 000000 Name: UNKNOWN
District: G
Parcel Number: 55072.0463
Block: Lot:
SiteAddress: 17109 E MONTGOMERY D
GREENACRES, WA 99016
Location:: GRE
Zoning: SR -1 Suburban Residential 1
Water District:
Owner: Name: CHANDLER, BOB & KATHI
Address: 17109 E MONTGOMERY DR
GREENACRES, WA 99016
Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Department Review
BUILDING Plan Review
Hold Reasons:
Permit Conditions:
Released By
IIEALTHDISTRICT Septic System Review
Hold Reasons:
Released By: .453
Permit Conditions:
Permits•
Project Number: 00005877 Inv: 1
� r
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 07/12/2000 Page 2 of 2
Contractor: OWNER
Address: 0
000000, 00 000000
Building Permit
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Const Category: Remodel Group:
Nbr Of Dwellings: Occupant Load:
Bldg W x D: x Building Sq Ft:
Req Parking. Handicap Parking:
Description Grp Tvpe
RESIDENCE R-3 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Payment Sun:utarv:
Operator: RMB
Permit Type
Building Permit
Notes• c
Type:
Building Height: Stories:
Sprinklers: ❑
Critical Materials: ❑
This Application: Total Project:
Sq Ft Valuation
0 $5,000.00
Notes So Ft Valuation
REMODEL 0 $5,000.00
Totals: 0 $5,000.00 0 $5,000.00
Units Unit Desc Fee Amount
1 Y OR BLANK $100.50
1 Y OR BLANK $4.50
1 Y OR BLANK $22.11
Permit Total Fees:
$127.11
Printed By: RMB Print Date: 07/12/2000
Fee Amount Invoice Amount
$127.11 $127.11
$127.11
$127.11
Amount Paid
$0.00
Amount Owing
$127.11
$0.00 $127.11
7.
ILl
AMI
SPOmitCowry
CC
- 5c61111
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description: /12471/7- O/ (». C ( 7-0 ue9d 490 'Z
TYPE OF APPLICATION
i Building Permit
,11-
El Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
11 Tenant (New/Change)
❑ Other
SPECIFIC SITE INFORMATION
Street Address: / 7/c 7 F re, ON7art X71 Y
❑ Applicane
Phone:
Fax.
Mailing Address.
/
7/0 9 i /'1 anY%('O/a7 ad V
Mailing Address:
Assessor's Tax Parcel Number(s): SJSo73 , a . /J--?
J
City, State, Zip
5'/?ee y 4c4e✓ vW4 9 90/C
City, State, Zip
Finished basement sq ft
❑ Contractor Phone
SW/ Fax
Legal Description:
5S(bn 3 . 5'-€
3
Mailing address
Mailing address
Heat source (electric, gas, etc
..,�.....y .... .tL...�II[i•.f'f '?,>..�➢!:':tmi
e partment:LJse:Onl
.....:..:....... :.t::..:', .,.:.: •... .
WA State Contractor license a
Contact name:
Water District/lun'c nr.,'; ['i=:';
:: :w➢'..A,1'r't •':".ir: :it .� .. �
.._ '. ".�u'FI,Yt,r�'ia,u „> <E„.:.�,».,',,.;:;
Sewer District/Purve or ii . ,: . .
y hilj vi-"'
"ieV �: ".
"'.1 :. '`;i iY.l-:.i.tr.[r•
FRoad width';
tl".j ',: ..�
”Setbacks
'iSetbv
Front:..,
'• .-`_
.Heir'
'School Disviiii^iitiy�ri'�;a''r••.
Fire District:
]Zoning-.'
.
°:..
OWNER/APPLICANT INFORMATION
Il Indicate who should he contacted regarding this project
,CJOwner: �/� - Phone
Dne
O CfJ (JJ4%4Z, c/4.®/l/1 Fax:
❑ Applicane
Phone:
Fax.
Mailing Address.
/
7/0 9 i /'1 anY%('O/a7 ad V
Mailing Address:
Dimensions
j.2,xaR
City, State, Zip
5'/?ee y 4c4e✓ vW4 9 90/C
City, State, Zip
Finished basement sq ft
❑ Contractor Phone
SW/ Fax
❑ Architect/Engineer
Phone
Fax
Mailing address
Mailing address
Heat source (electric, gas, etc
City, State Zip
City, State Zip
WA State Contractor license a
Contact name:
PROJECT INFORMATION
:... ..., . ill Ing Informatlori
-
Budding height to peak
# of stories
Ma'n (loot sq. ft.
Unfinished basement sq ft
Dimensions
j.2,xaR
Total habitable space
2' floor sq ft.
Finished basement sq ft
Occupancy group
Construction type
Garage sq. ft
Deck sq. ft.
Cost of project
S'poGQ 0
Heat source (electric, gas, etc
Manufactured Home --
Sign
Width:
Length:
What is the square footage of the sign
face?
How high is the sign?
Year:
Make:
# of signs
Area of existing signs
Relocation
Fire Safety
Firm Name
What is the current use of this property?
Previous address
Will the site be served by a septic system? O Yes O No
Paint booth
Fire Sprinkler
Tent
_
Fire Alarm
Fireworks display
Are critical or hazardous materials used or stored on site?
O Yes O No
Address
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property?
Phone
Will the site be served by a septic system? O Yes O No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
O Yes Cl No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(/ oh) O Yes O No
Are critical or hazardous materials used or stored on site?
O Yes O No
Address
Inspector
Phone
O Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes O No
If yes, identify on site plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
If yes, identify on site plan O Yes O No
What is the current use of this property?
Is your property in a designated wildlife habitat area?
O Don't know O Yes O No
Will the site be served by a septic system? O Yes O No
Is any part of the property within a 100 yr flood plain?
If yes, identify on site plan
O Maybe O Don't know O Yes O No
Are or will there be wells located on the property?
If yes, identify on the site plan O Yes O No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identf on site plan O Yes O No
Is there evidence of fill or excavation on the property?
O Yes Cl No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(/ oh) O Yes O No
Are critical or hazardous materials used or stored on site?
O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
O Yes O No
Is public sewer available to the site? O Yes O No
Is the property inside the ASA?
O Yes
O Yes
O No
O No
Is public water available to the site? O Yes O No
Is the property inside the PSSA?
O Yes
O No
Is the property located within 1000 feet of a Natural Resource
Area? O Yes O No
Date Received:
Staff Representative: