2002, 11-22 Permit App: 02010519 Remodel Project Number: 02010519 Inv: 1 Application Date: 11/22/2002 Page 1 of 2
THIS IS NOT A-PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: FINISH 4TH LEVEL (BEDROOM &PERSONAL Contact: JOPPA,DONALD R.
OFFICE AREA) Address: 3602 S VERCLER DR
C - S -Z: SPOKANE,WA 99206
Setbacks: Front Left: Right: Rear: Phone: (509) 892-1031
Group Name:
Site Information: Project Name:
Plat Key: 006071 Name: MIDILOME EAST 2ND ADD District: F
Parcel Number: 45342.0907 Block: 1 Lot: 7
SiteAddress: 3602 S VERCLER DR Owner: Name: JOPPA,DONALD IL
SPOKANE,WA USA 99206 Address: 3602 S VERCLER DR
Location::SPO SPOKANE,WA 99206
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 12,750 Sq Ft Width: 85 Depth: 150 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Plan Review Released By: t � '2.Z`O2
Permits:
Operator: CKF Printed By: CKF Print Date: 11/22/2002
Project Number: 02010519 Inv: 1 Application Date: 11/22/2002 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
Phone:
Building Characteristics
Const Category: Remodel Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials:
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT R R-3 VN 503 $2,258.47 503 $2,258.47
Totals: 503 $2,258.47 503 $2,258.47
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $75.50
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $16.61
Permit Total Fees: $96.61
Notes .
Payment Summary
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $96.61 $96.61 $0.00 $96.61
$96.61 $96.61 $0.00 $96.61
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 construed 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: CKF Printed By: CKF Print Date: 11/22/2002
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
509-477-3675
SPOKE COUNTY
SPECIFIC SITE INFORMATION w
Street Address: Go Z 5 v M-t 02 S P 014/20,1 G -(Ct Z-IY0
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: 3ASEmokrr.
C1 Building Permit 0 Change in Use CI Grading CI Manufactured Home Permit
CI Relocation O Sign 0 Tenant(New/Change) CI Other
Department Use Only
WaterDistrict/Purveyor. Sewer District/Purveyor Road width Setbacks
Front Rear
School District Fire District: Zoning
Left: Right:
OWNER/APPLICANT INFORMATION
lndirale alio should he,nntailed regarding;lhil pr jed
XOwner Phone: sq-z-163( P'Applicant: //�� .�tN• Phone
De .1t!}%.() 2 stopp4 l'ax: s'Ft e , Fax:
Mailing Address: Mailing Address:
3G 02 5 UEncL- L Oif--
City,State,Zip City,State,Zip
Si oiCA i 0,A 99
Phone
ElContractorContractor ❑ Architect/lngincer
Fax lax
Mailing address Mailing address
City,State Zip City,State Zip
Vi A State Contractor license# Contact name:
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
Dimensions Total habitable space 2"d floor sq.ft. Finished basement sq.ft.
, -) c SQ F, -
Occupancy group Construction t}'pe Garage sq.ft. Deck sq. ft.
Cost of project I'cat source(electric,gas,etc.)
Manufactured Home Sign
Width: Length: What is the square footage of the sign I low high is the sign?
face?
Year: Make: #of signs Area of existing signs
Relocation Fire Safety
Previous address Fire Sprinkler fent
Paint booth Fire Alarm Fireworks display
Proposed use Value
Special Inspections Required? Non-Residential Energy Code Compliance?
Firm Name Phone I'lans Examiner Phone
Inspectors: Address
Inspector Phone
O Concrete O Welding O Bolting O Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes O No What is the current property size?
If yes,identify on site plat (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
If yes,ideirt fr on site plat 0 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? Arc or will there be wells located on the property?
If yes,identify on site plan If yes,identify on the site plan El Yes 0 No
O Maybe O Don't know O Yes O No
Are there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property?
Ifj'es,identify on site plan O Yes O No O Yes O No
Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) Arc critical or hazardous materials used or stored on site?
( %) O Yes O No O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? O Yes O No
OYes 0 N
Is the property inside the ASA? O Yes O No Is public water available to the site? O Yes 0 No
O Yes O No
Is the property inside the PSSA? O Yes O No Is the property located within 1000 feet of a Natural Resource Area?
OYes 0 N
Date Received: Staff Representative:
METHOD OF PAYMENT
MENNE
S€ O' SUB"1'O"f,il.
VISA
❑ CASH ❑ CHECK ❑ ❑ ❑ :"
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
ll:A7'F: EXPIRES: TOTAL FEE
BANK(.:ARD NUMBER: MINIMUM PERMIT FEE IS$35.I PLEASE
MAKE CI IECKS PAYABLE TO SPOKANE
AUTI 10R1'/.FD SIGNATURE: COUNTY PERMIT CENTER