2002, 06-07 Permit App: 02004562 Addition, Remodel Project Number: 02004562 Inv: 1 Application Date: 6/7/02 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: RES ADD-BEDROOM ADDITION &REMODEL Contact: STRALKA,DAVID&DANA
EXISTING FOR BATHROOM Address: 503 S STEEN RD
C-S-Z: VERADALE,WA 99037-8912
Setbacks: Front 68 Left: 20 Right: Rear: Phone: (509)228-9496
Group Name:
Site Information: Project Name:
Plat Key: 999999 Name: RANGE District: F
Parcel Number: 45241.9066 Block: Lot:
SiteAddress: 503 S STEEN RD Owner:Name: STRALKA,DAVID&DANA
VERADALE,WA USA 99037 Address: 503 S STEEN RD
Location::VER VERADALE,WA 99037-8912
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: .91 Acres Width: 200 Depth: 200 Right Of Way(ft): 0
Nbr of Bldgs: 2 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review Release —72 —
Plan ReviewReleas - 6
4U74L teview Released By: 4/7/
Sewage system desicji.
ftw 3 bedrooms only.
Permits:
Operator: JAS Printed By: JAS Print Date: 6/7/02
Project Number: 02004562 Inv: 1 Application Date: 6/7/02 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: OWNER Firm: OWNER
Phone:
Building Characteristics
Const Category: Addition Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories: 1
Bldg W x D: 29 x 12 Building Sq Ft: 348 Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials:
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RES ADD R-3 VN 348 $22,968.00 348 $22,968.00
Totals: 348 $22,968.00 348 $22,968.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $325.50
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $71.61
Permit Total Fees: $401.61
Mechanical Permit
Contractor: OWNER Firm: OWNER
Phone:
Item Description Units Unit Desc Fee Amount
DUCT SYSTEMS 1 NUMBER OF $10.00
VENTILATING FANS 1 NUMBER OF $10.00
MINIMUM FEE ADJUSTMENT 1 Select $15.00
Permit Total Fees: $35.00
Plumbing Permit
Contractor: OWNER Firm: OWNER
Phone:
Item Description Units Unit Desc Fee Amount •
TOILETS/BIDETS 1 NUMBER OF $6.00
SINKS 2 NUMBER OF $12.00
SHOWERS 1 NUMBER OF $6.00
TUBS 1 NUMBER OF $6.00
MINIMUM FEE ADJUSTMENT 1 Select $5.00
Permit Total Fees: $35.00
Operator: JAS Printed By: JAS Print Date: 6/7/02
ir
Project Number: 02004562 Inv: 1 Application Date: 6/7/02 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $401.61 $401.61 $0.00 $401.61
Mechanical Permit $35.00 $35.00 $0.00 $35.00 '
Plumbing Permit $35.00 $35.00 $0.00 $35.00 •
$471.61 $471.61 $0.00 $471.61
Disclaimer:
Submittal of this application certifies the owner(or person(s)authorized by the owner)has both examined and finds the information
contained within to be true and correct,and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be contrued to be a permit for,or an approval of,any violation of any of the
provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JAS Printed By: JAS Print Date: 6/7/02
PROJECT APPLICATION WORK SHEET
A
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
2,4
1026 WEST BROADWAY AVENUE
����
I � SPOKANE,WA 99260
SPO CWMJY 509 477-3675
SPECIFIC SITE INFORMATION
• Street Address: Q
,.6.-2.)- S Src-Eiv. F /
Assessor's Tax Parcel Number(s):
15-;v4/- .9066
Legal Description: ��ll
SL=E /�`7,yC/1.02
Project Description: .$'&W" .4177i9G17l—
❑ Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
❑ Relocation CI Sign ❑ Tenant(New/Change) 0therx4. frl4e..2 =L
Department Use Only
Water District/PurveyorSewer District/Purveyor -. Road width cks
Setbi . _ - . ..•
/,//� ' ` Front. Rear.
6 LNi9TE-.A. <,Z-4V7/1' �
School District Fire District: - - 7.oSmg•
63 14Left Right
OWNER/APPLICANT INFORMATION
El Indicate oho.hop ld he contatied rrp,ardlgg/hi,pnged
ncr. Phone: �} /
IKON. �j�GJ9,2�'�-/9Sp ❑clpplicanr Phone:
i
DAL'/O 4'/�ANA T.QALXd1 rax: Fax:
Mailing Address: Mailing Address'
Cin,,State,Zip
,'�
// Circ,State,Lip
f4-/l/9lJALE 1l/A,
❑ Corti MOM
Phone Phone
❑Architect/Engineer
Fac
Mailing address Fax
Mailing address
Cin-,Gate Zip
City,State lip
\C:A State Contractor license= Contact name
PROJECT INFORMATION
Building Information — - /�.p,0/7/e/A)C&X. ,)
Building height to peak #of stories Alain floor sq.It. Unfinished basement sq.ft.
/ "
Dimon,ions -Poral habitable space 2'"1 floor sq.ft. Finished basement sq.ft.
/� X u(9 / x 9 ' //
Occupancy group Construction tope Garage sq.ft. Deck sq.ft.
•
Cost of project I k-at source(electric.gas.etc.)
Manufactured Home ,16
Sign
Width: length: What is the square footage of the sign How high is the sign?
face?
Year: Make: #of signs
� Area of existing signs
Relocation Fire Safety-
Previous address
Fire Sprinkler Tent
Paint booth_ Fire Alarm _ Fireworks display
Proposed use
Value
Special.Inspections Required? Non-Residential Energy Code Compliance?
Finn Name Phone
Plans Examiner Phone
Inspectors:
Address
Inspector Phone
O Concrete O Welding O Bolting O Reinforcement • Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? X Yes O No What is the current property size?
fyes,ident on site plan ware feet or acres)
Is any part of the propcm within 250(est of a sh reline? (9 a 9.2 '9e49.5
What is the current use of this property?
Ifyes,irlent on site plan O Yes No
Is your property in a de ignated wildlife habitat arca? Will 'F 3-110e-A,77.91-
the site be served by a septic system?X Yes O No
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,identi.fr on site plan
Ifyes,ideal f on the sitean/
O Maybe O Don't know O Yes No p O "cs No
Arc there any wetlands,streams or ponds within 200.feet of the property? Is there evidence of fill or excavation on the property?
Ifyes,iderdO,on site plan O Yes X No
Arc there slopes greater than 30%on the property? \re critical or
?(30 ft rise in 100 ft) O Yes X No
hazardous materials used or stored on sits?
( %) O Yes X No
O Yes ptNo
DEPARTMEN_T USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? O Yes O No
O Yes O No
Is the property inside the ASA?. O Yes O No Is public water available to the site? O Yes O No
O Yes O No
Is the property inside the PSSA? O,Yes O No Is the propertylocated within 1000 feet of a Natural Resource Area.
>
Date Received:
Yes O No
Staff Itrpr.scntat,vc-
METHOD OF PAYMENT I
VISA
- r` ei �ltK'fO'1'.1J-
(-1`11 CHECK p 0
0 .
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
HATE -
EXPIRES':
BANKCARD NUMBER: TOTAL FEE
MINIMUM PERMIT FEE IS$35.00Pt.f.i5 F
.1U'(1)(BRED SIGN.\"I-URE: AKl.'.CHECKSPaS.tsft to l o1:1Xt.
rawNTY PERMI t CENTER