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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: ` De BUI 4 HE 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 ti..,Ek q�3,? Wwth- .�L3MItERAir7`fEEISt3�603',LEA'��. i�t;:CFtEt;K53KAYABI,Ei"O�S3'O$i11�1E,.� " �? ��,*�•,