2002, 02-20 Permit App: 02001043 ResidenceProject Number: 02001043 Inv: 1
Application
r ,
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/20/02
Project Information:
Permit Use: RESIDENCE W/GARAGE - GAS
Setbacks: Frontpjak Left: % 'Right:� tear: 200
Site Information:
Plat Key: 005119 Name: SP -703-91
Page 1 of 4
Contact: BERG, R A & J I
Address: 18311 E RIVERWAY AVE
C - S - Z: GREENACRES, WA 99016-9361
Phone: (509) 927-4444
Group Name:
Project Name:
Parcel Number: 55075.2908 Block: �n Lot: A
SiteAddress: 18313 E RIVERWAY$( *Owner: Name: BERG, R A & JI
GREENACRES, WA USA 9901
Location:: GRE
District: G
Address: 18311 E RIVERWAY AVE
GREENACRES, WA 99016-9361
Zoning: UR -7 Urban Residential -7
Water District: 008 CONSOLIDATED IRRG #1 Hold: ❑
Area: .80 Acres Width: 90 Depth: 330 Right Of Way (ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
Critical Area Review
Shoreline Review
Approach/ Drainage
Released By: 41/4+01
SSC
siktptrui
d>d_r_or \s -
Released By:
Released By:
41,torm k-Sti 0?sL.A1A$
o s -u n4 ► -Lk)
Operator: JAS
a cJ
Printed By: JAS
2/20/0
Print Date:
Project Number: 02001043
Q11
Permits:
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/20/02
Flood plain
Septic System Review
Page 2 of 4
Released By: 0
Contractor: OWNER
Address: 0
000000, 00 000000
Const Category: New
Nbr Of Dwellings: 1
Bldg W x D: x
Req Parking:
Building Permit
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Group: R-3 Type: VN
Occupant Load: Building Height: 35
Building Sq Ft: 3878 Sprinklers: ❑
Handicap Parking: Critical Materials: E
Description Grp Type Notes
2ND FLOOR R-3 VN
BASEMENT U R-3 VN
DECK R-3 VN
GARAGE 1.1-1 VN
RESIDENCE R-3 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Stories: 2
This Application: Total Project:
Sq Ft Valuation Sq Ft Valuation
618 $38,316.00 618 $38,316.00
1,598 $18,472.88 1,598 $18,472.88
200 $1,472.00 200 $1,472.00
1,246 $14,952.00 1,246 $14,952.00
1,662 $103,044.00 1,662 $103,044.00
Totals: 5,324 $176,256.88 5,324 8176,256.8$
Units Unit Desc
Operator: JAS Printed By: JAS
Y OR BLANK
Y OR BLANK
Y OR BLANK
Permit Total Fees:
Fee Amount
$1,280.00
$4.50
$281.60
$1,566.10
Print Date: 2/20/02
02/21/2002 THU 12:53 FAX 509 477 7532 5PO1(ANE CO BLDd-CODE ENF 4+-4 HEALTH -BACK OFFICE a002/004
Project Number: 02001043
Inv: 1
Applr'catioti
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2120/02
Page 2 of 4
Septic System Review
tlett 41 Sae* "It
Permits: e:-a+•s.,wwfmr‘n;wvr. nnesr m+:
Contractor: OWNER
Address: 0
000000, 00 000000
Cons; Category: New
Nbr Of Dwellings: 1
Bldg W x D:
Req Parking:
Description Gry
2ND FLOOR R-3
BASEMENT U R-3
DECK R-3
GARAGE 0-1
RESIDENCE R-3
Released By::
Baa:asa marnmancao^;c sc tmeara acustpAstm+.., .-�. ice,,,•
Building Permit — - -
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Group: R-3 Type: VN
Occupant Load: Building Height: 35
Building Sq Ft: 3878 Sprinklers: E
Handicap Parking: Critical Materials:
-• This Application:
Tine Notes Sq Ft Valuation
VN 618 338,316.00
VN 1,598 S18,472.88
VN 200 51,472.00
VN 1,246 514,952.00
VN 1,662 3103,044.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Operator: JAS
Totals: 5,324 $176,256.88
Units Unit nese
1 Y OR BLANK
Y OR BLANK
Y OR BLANK
Permit Total Fees:
Printed I3y: JAS Print Date:
Stories: 2
Total Project:
Sa Ft Valuation
618 $38,316.00
1,598 518,472.88
200 51,472.00
1,246 $14,952.00
1,662 $103,044.00
5,324 $176,256 88
Fcc Amount
$1,280.00
$4.50
$281.60
51,566.10
2/20/02
Project Number: 02001043 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/20/02 Page 3 of 4
Contractor. OWNER
Address: 0
000000,00 000000
Item Description
DUCT SYSTEMS
WOOD/PELLET STOVE/INSERT
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS
CLOTHES DRYER
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
CLOTHES WASHER
FLOOR DRAINS
CROSS CONNECTION DEVICES
WATER USING DEVICES
Mechanical Permit
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 # OF UNITS
1 NUMBER OF
5 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Plumbing Permit
Firm: OWNER
Phone: (000) 000-0000
Fee Amount
$10.00
$25.00
$10.00
$12.00
$3.00
$12.00
$50.00
$10.00
$132.00
Units Unit Desc
5 NUMBER OF
7 NUMBER OF
2 NUMBER OF
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Operator: JAS Printed By: JAS
Permit Total Fees:
Print Date:
Fee Amount
$30.00
$42.00
$12.00
$18.00
$6.00
$6.00
$6.00
$6.00
$18.00
$144.00
2/20/02
4
Project Number: 02001043 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/20/02 Page 4 of 4
Notes:
Payment Summary -
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owinp_
Building Permit $1,566.10 $1,566.10 $0.00 $1,566.10
Mechanical Permit $132.00 $132.00 $0.00 $132.00
Plumbing Permit $144.00 $144.00 $0.00 $144.00
$1,842.10 $1,842.10
$0.00 $1,842.10
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: 2/20/02
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RIVERWAY R0/,4\D �
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New Marling Address Fad„Frc�,'
Ric & Jean Berg t cb M �r
18313 E. Riverway
-jo, Greenacres, WA 99016
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VOTES:
SEE FINAL SHORT PLAT NO. 87-521 AND 7--91`a,� �S
(� tL ADDITIONAL SURVEY INFORMATION. \
A.CCURACE STATEMENT
This survey was performed using a Zeiss TH 4