2001, 05-17 Permit App: 01003699 Change of UseProject Nuniber: 01003699 Inv: 1 Applica' Son Date: 5/17/01 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for Commencing work without a permit
Parcel Number: 55184.3114 Block: Lot:
SiteAddress: 18010 E SPRINGFIELD AVE
GREENACRES, WA 99016
Location:: GRE
Zoning: UR -3,5
Water District:
Area: 11,691 Sq Ft Width: 85
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: `
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Permits:
Owner: Name: PETERSON, MERRILL
Address: 14523 E 6TH
SPOKANE WA 99216
Hold: ❑
Depth: 121 Right Of Way (ft): 50
Ho Reasons:awtsga__>tpatrnrdaSrgR
Permit Conditions: jW Z, b�e&aoms__nnly_
Project Number: 01003699 Inv: 1 4Lpplication Date: 5/17/01 Page'2 of 2,
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
-- — Building Permit
Contractor: OWNER Firm: OWNER
Address: 0 Phone: (000) 000-0000
000000, 00 000000
Building Characteristics
Const Category: Change Of Use Group: LC -1 Type: VN
Nbr Of Dwellings: Occupant Load: 6 Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: El
Req Parking: Handicap Parking: Critical Materials: El
This Application: Total Project:
Description Grp Tyne Notes SQ Ft Valuation Sq Ft Valuation
RESIDENCE LC VN LCOCCUPA 0 $1.00 0 $1.00
NCY
Totals: 0 $1.00 0 $1.00
Item Description Units Unit Desc Fee Amount
CHANGE OF USE/SAFETY INSP 1 Y OR BLANK $50.00
STATE SURCHARGE 1 Y OR BLANK $4.50
Permit Total Fees: $54.50
Payment Summa
_ ► PIZOJEC�' APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
1t1( SPOKANE, WA 99260
�P(IKANV Cil Mry 509-477-3675
SPECIFIC: Sn-F TMFnRMA "nN
Street Address: to lo
f-r� Ar/
Assessors Tax Parcel Number(s):
Legal Description:
Project Description:
fO Building Permit O Change in Use O G ading O Manufactured Home Permit
O Relocation O Signarenant (New/Change) O Other
OWNER/APPLICANT INFORMATION
TION
51i
Building height to peak
!/ of stones
Main floor sq fr.
Unfinished basement
sq h_
Dimensions
Total habitable ace s
P
a
2" floor sq. ft-
Finished basement sq. h.
Dccupancy group
Consiniction type
Garage sq. ft.
Deck sq. h.
ost of project
Heat source (electric, gas, etc.)
address
Proposed use
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes O No
What is the current property size?
I yes, identify on site plan
(square feet or acres
Is any part of the property within 250 feet of a shoreline?
What is the current use of ibis property?
1 Yes, identifi on site plan O Yes O No
Is your property in a designated wildlife habitat area?
Will the site be served by a septic system? O Yes O No
O Don't know O Yes O No
Is any part of the property within a 100 yr flood plain?
Are or will there be wells located on the property?
If yes, identify on site plan
If yes, identify on the site plan Cl Yes O No
O Maybe O Don't know O Yes O No
Are there any wetlands, streams or ponds within 200 feet of the
Is there evidence of fill or excavation on the property?
property? t
O Yes O No
I es, identify on site pLan O Yes O No
Are there slopes greater than 3096 on the property? (30 It rise in -100h)
Are critical or hazardous materials used or stored on site?
% O Yes O No
O Yes O No
DEPARTMENT USE ONLY
Date Receivcd:
METHOD OF PAYMENT
yZI
❑ CASH ❑ CHECK ❑ 13 ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE: EXPIRES: --
RANKCARD NUMBER:._______
AUTHORIZED SIGNATURE
SUBTOTAL
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