2001, 12-31 Permit App: 01011104 RemodelProject Number: 01011104 Inv: 1
;- Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/31/01 Page 1 of 3
Protect Information:
Permit Use: FINISH BASEMENT - (2) BEDROOMS, FAMILY
RM, LAUNDRY RM, BATHROOM
Setbacks: Front Left:
Right: Rear:
Site Information:
meetetteste
Plat Key: 002761 Name: VERADALE PARK ADD
mgaffstEst, J4`Ati.- o"+hn %;'' FM»%... $T4''.,4 ,.a.
Contact: HAUGEN, KIM M
Address: 1024 N ST CHARLES RD
C - S - Z: VERADALE, WA 99037
Phone: (509) 927-1692
Group Name:
Project Name:
District: F
Parcel Number: 45141.0409 Block: 4
SiteAddress: 1024 N ST CHARLES RD
VERADALE, WA USA 99037
Location:: VER
Zoning: UR -7
Water District:
Urban Residential -7
Area: .00 Acres
Nbr of Bldgs: 1
Review Information:
Width: 0
Nbr of Dwellings: 1
Lot: 9
Owner: Name: HAUGEN, KIM M
Address: 1024 N ST CHARLES RD
VERADALE, WA 99037
Hold: O
Depth: 0 Right Of Way (ft): 0
Review
Plan Review
Septic System Review
5ev,aja
for bedrooms
LAr
Permits:
44.41,
74t.e..
Operator: CKF Printed By: CKF
0J
Print Date: 12/31/01
Project Number: 01011104 Inv: 1
Application _,
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/31/01 Page 2 of 3
Building Permit
Contractor: OWNER Firm: OWNER
Address: 0 Phone: (000) 000-0000
000000, 00 000000
Building Characteristics
Const Category: Remodel Group: R-3 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height:
Bldg W x D: x Building Sq Ft: 1010 Sprinlders:
Req Parking: Handicap Parking: Critical Materials: 0
Description Grp Tvne Notes
BASEMENT R R-3 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
DUCT SYSTEMS
GAS PIPING
VENTILATING FANS
GAS LOG OR GAS INSERT
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
TOILETSBIDETS
SINKS
TUBS
SEWAGE EJECTOR
WATER PIPING - DWV
Operator: CKF
Stories:
This Application: Total Project:
Sq Ft Valuation Sa Ft Valuation
1,010 $4,242.00 1,010 $4,242.00
Totals: 1,010 $4,242.00 1,010 $4,242.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Mechanical Permit
Fee Amount
$100.50
$4.50
$22.11
$127.11
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc Fee Amount
1 NUMBER OF $10.00
1 # OF UNITS $1.00
2 NUMBER OF $20.00
1 NUMBER OF $10.00
Permit Total Fees: $41.00
Plumbing Permit
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Printed By: CKF
Permit Total Fees:
Fee Amount
$6.00
$12.00
$6.00
$6.00
$6.00
$36.00
Print Date: 12/31/01
Project Number: 01011104 Inv: 1
• Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/31/01 Page 3 of 3
Notes........
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$127.11
$41.00
$36.00
aCYM
Invoice Amount
$127.11
$41.00
$36.00
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$127.11
$41.00
$36.00
$204.11 $204.11 $0.00 $204.11
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be contrued to be a permit for, or an approval of, any violation of any of the
provisions of tie code or of any other state or local laws or ordinances.
Signature:
Operator: CKF Printed By: CKF
Print Date: 12/31/01