2000, 06-12 Permit App: 00004890 RemodelProject Number: 00004890
Inv: 1
__Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 06/12/2000 Page 1 of 2
Project Information:
Permit Use: FINISH BEDROOM AND CLOSET IN BASEMENT
Setbacks: Front Left:
Right: Rear:
Site Information:
Plat Key: 005862 Name: SHELLEY LAKE
IMMORTAMOMIAMONSMNRiX
Contact: SIMON WAY & COMPANY
Address: 504 E JOSEPH AVE
C - S - Z: SPOKANE WA 99207
Phone: (509) 482-0452
Group Name:
Project Name:
District:
Parcel Number: 45241.9027
Block:
SiteAddress: 423 S SHELLEY LAKE LN
GREENACRES, WA 99016
Location:: GRE
Zoning: UR -3.5
Water District:
Area: 0 Sq Ft
Nbr of Bldgs: 1
Review Information:
Department
BUILDING
Permits:
Urban Residential 3.5
Lot:
Owner: Name: ROGERS, KURT
Address: 423 S SHELLEY LAKE LN
GREENACRES, WA 99016
Hold: ❑
Width: 73 Depth: 109 Right Of Way (ft): 50
Nbr of Dwellings: 1
Hold Reasons:
Permit Conditions:
Plan Review
Project Number: 00004890 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 06/12/2000 Page 2 of 2
Contractor: SIMON WAY & COMPANY
Address: 504 E JOSEPH AVE
SPOKANE, WA 99207
Building Permit
Firm: SIMON WAY & COMPANY
Phone: (509) 879-6955
Building Characteristics
Const Category: Remodel Group:
Nbr Of Dwellings: Occupant Load:
Bldg W x D: x Building Sq Ft:
Req Parking: Handicap Parking:
Description Gru Dm Notes
RESIDENCE R-3 VN REMODEL
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Payment Summary:
Operator: DMD
Permit Type
Building Permit
Totals:
Type:
Building Height: Stories:
Sprinlders:
Critical Materials: ❑
This Application: Total Project:
Su Ft Valuation Su Ft Valuation
0 $2,540.35 0 $2,540.35
0 $2,540.35
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
0 $2,540.35
Fee Amount
$75.50
$4.50
$16.61
$96.61
Printed By: DMD Print Date: 06/12/2000
Fee Amount Invoice Amount Amount Paid Amount Owing
$96.61 $96.61
$0.00 $96.61
$96.61
$96.61
$0.00
Notes
OCCUPANCY IS DENIED ON ALL LOTS UNTIL FURTHER NOTICE
FROM DIV. OF UTILITIES PER GENE REPP 3/26/97 CKF OK TO ISSUE
SEWER PERMITS FOR: BLOCK 2 - LOTS 3 THROUGH 10 & 1, 2
BLOCK 3 - LOTS 1 THROUGH 7 BLOCK 4 - LOTS 1 THROUGH 4
BLOCK 5 - LOTS 2 THROUGH
6 & 19 BLOCK 6 - LOTS 1 THROUGH 10
$96.61
lh I
Aiilik
r
SPOKE COUNTY
Project Description:
`PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260 ,/�
509-477-3675 l7, T
UNk/'( t-46kbiezzw,
TYPE OF APPLICATION
`Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
SPECIFIC SITE INFORMATION
Street Address: A 2-:3
/-' -e� t-< Lar\i '
(ikkA"
p
Assessor's Tax Parcel Number(s):
t
Legal Description:
Finished basement sq. ft.
Department Use Only
p
Water District/Purveyor:
Sewer District/Purveyor
Road width
Setbacks
Front:
Left:
Rear:
Right:
School District:
Fire District:
Zoning
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
.,21 Owner: Phone: F�/t 72._-152.5
A� "/ Fax: :/7L 1�25
❑ Applica {J q
��t t �Wt V
/ f l�
(Jv� ` (
Phone:
Fax:
Unfinished basement sq. ft.
Mailing Address
Mailing Address:
/
Finished basement sq. ft.
Occupancy group
p
Garage sq. ft.
City, State, Zipr .1....h6... vCity,
State, Zip
Heat source (electric, gas, etc.)
)',
(p
(l
q61 -1-C7
)21 ContGr �t)pr /I , (y� I1 116164-( q}�/�Phone l� t - / S g�
c_/ 1 6L4C7 ' \' ax 4g2_- 04,-5-3--
❑ Architect/Engineer
Phone
Fax
Mailing address( �1 /
Mailing address
City, State Zip __ (A -14Z_
_,` �� ' . \µ/} �{(�/
City, State Zip
WA State Contractor license N
St cJ\lC0 26 b7
Contact name:
PROJECT INFORMATION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
2' floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
Heat source (electric, gas, etc.)
Manufactured Home
InspectionsRequired?
iSign
Width:
Length: #-
What tithe square footage of the sign
face?
How high is the sign?
Year:
Make:
# of signs
Area of existing signs
Previous address
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
Proposed use
Value
Special
InspectionsRequired?
Non -Residential Energy Code Compliance?
Firm Name
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?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(/ %) 0 Yes 0 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 0 Yes 0 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
0 Maybe 0 Don't know 0 Yes 0 No
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes 0 No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identify on site plan 0 Yes O No
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(/ %) 0 Yes 0 No
Are critical or hazardous materials used or stored on site?
0 Yes 0 No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater-Control Area?
O Yes O No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA?0
Yes
O Yes
0 No
O 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? 0 Yes 0 No
Date Received:
Staff Representative: