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2001, 03-28 Permit App: 01001936 AdditionProject Number: 01001936 Inv: 1 Application Date: 3/28/01 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: RESIDENCE ADDITION - BEDROOM & FAMILY Contact: DERRICK, KEVIN SCOTT ROOM Address: 916 N WOODRUFF RD C - S - Z: SPOKANE, WA 99206 Setbacks: Front 100 Left: 25 Right: 49 Rear: NA Phone: (509) 922-2436 Group Name: Site Information: Project Name: Plat Key: 001855 Name: OPPORTUNITY SUB.TR.99 District: F Parcel Number: 45171.1103 Block: Lot: SiteAddress: 916 N WOODRUFF RD Owner: Name: DERRICK, KEVIN SCOTT SPOKANE, WA 99206 Address: 916 N WOODRUFF RD Location:: SPO SPOKANE, WA 99206 Zoning: UR -3.5 Urban Residential 3.5 Water District: Area: 0 Sq Ft Width: 90 Depth: 312 Right Of Way (ft): 0 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Hold: ❑ Review Information: Department BUILDING Hold Reasons: Permit Conditions: BUILDING Hold Reasons: Permit Conditions: Review Site Plan Review Plan Review HEALTHDISTRICT Septic System Review Hold Reasons: Permit Conditions: e4.6-6, 42 A Released By: t VIOL Released By: 4 `tet "Crej.AjL; - Released By: Permits: Project Number: 01001936 Inv: 1 Applicatio1l THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 3/28/01 Page 2 of 2 Contractor: FOLEY ENTERPRISES Address: 22712 E RED FEATHER LN Phone: (509) 926-1514 LIBERTY LAKE, WA 99019 Building Characteristics Group: R-3 Type: VN Building Height: 12 512 Sprinklers: ❑ Critical Materials: ❑ This Application: Sq Ft Valuation 512 $31,744.00 Building Permit Firm: RICH FOLEY ENTERPRISES Const Category: Nbr Of Dwellings: Bldg W x D: 16 Req Parking: Description RES ADD Addition Occupant Load: x 32 Building Sq Ft: Handicap Parking: Grp Type Notes R-3 VN Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Payment Summary: Operator: CKF Permit Type Building Permit Totals: 512 $31,744.00 Units Unit Desc 1 Y OR BLANK 1 Y OR BLANK 1 Y OR BLANK Printed By: CKF Permit Total Fees: Stories: 1 Total Project: Sq Ft Valuation 512 $31,744.00 512 $31,744.00 Fee Amount $415.00 $4.50 $91.30 $510.80 Print Date: 3/28/01 Fee Amount Invoice Amount $510.80 $510.80 $510.80 $510.80 Notes:._ Amount Paid $0.00 $0.00 Amount Owing $510.80 $510.80 SPOKANE C0uFUY t�, PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: cAltoM • WooLUPP Assessor's Tax Parcel Number(s): Legal Description: i-fs 171[(1®3 Project Description: An) D €1%e-coii.4 c-AiYu ( Thom (0 a (S—rr t{OO& .Building Permit O Change in Use O Grading O Manufactured Home Permit 0 Relocation O Sign 0 Tenant (New/Change) O Other OWNER/APPLICANT INFORMATION El Indicate who should be contacted regarding this projea Phone: 4 4 u— 14310 0 Owner. 5[7 K(Lot&) SLOT( ✓f� garezk- Fix: 0 Applicant: Phone: Fax: Mailing Address: q►ce 0 (,ei RoPE6Q\ Mailing Address: City, State, Zip Qp tffi 3a w A qg ZOb Ciry, State, Zip ® Cont or Phone - /$-/Phone 9� D e.Lf �1i / ey�%/Se•S Fax 7�� _/�/ 0 Architett/Engineer Fax M ding address 127/Z E. Ted AJher H' Mailing address City, State Zip I-4 AerG.a Ke , Wei 990/9 Ciry, State Zip WA State Contra or license f rbG.e`l ED (Co PS Contact name: PRO ECT INFORMATION Building height to peak N of stories Ditneniions O X 3Z `. Total habitable space 57 2— Main floor sq. ft. S/Z c9 2"d floor sq. . N/R- Unfinishedbpsemens sq. ft. Occupancy group SIaG Ic Construction tyke S§rlC L Garage sq. ft. Nii- Finishedb ement sq. h. �� Deck sq. t Cost afp 201 DOD Heat source (electric, gas, etc) S[-tcr2/c oactt A/2 Width: Length: t What is the square footage of the sign face? How high is the sign? Year: Make: A of signs Area of existing signs Fire Sprinkler Paint booth Fre Alarm Tent Fireworks display Proposed use Value Firm Name Phone Plans Examiner Phone Inspectors Address Inspector Phone ID Concrete ❑ Welding O Bolting O Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? O Yes O No Ifyes, identify on site plan What is the current property size? (square feet or acres) Is any part of the property within 250 feet of a shoreline? If yes, identify on site plan •O Yes O No What is the current use of this property? Is your property in a designated wildlife habitat area? O Don't know O Yes O No Will the site be served by a septic system? O Yes O No Is any pan of the property within a 100 yr flood plain? If yes, identify on site plan O Maybe O Don't know O Yes ❑ No Are or will there be wells located on the property? If yes, identify on the site plan O Yes ❑ No Are there any wetlands, streams or ponds within 200 feet of the property? Ifyes, identify on site plan O Yes ❑ No Is there evidence of fill or excavation on the property? O Yes O No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) (/%) OYes 0 N Are criticalaochazardous materials used or stored on site? ❑Yes 0 N DEPARTMENT USE.ONLY Due Received: Staff Representative METHOD OF PAYMENT VASO ❑ CASH ❑ CHECK ❑=NM ‘, Li FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: I NTA This site Plan Is being submitted for the purpose Of obtaining building permit and is a true and correct representation of the proposal, All IMOWO PmPerly linesUrna,sions, curb lines, structures and easements have been identified. Also Inds ioratVedParIe �vetlanad1cs8, bodies of water, st pspa Signed: : s. - I -- -3l2._._ �Rid£vJR� W 0-r 31Z..- 0 -r: 30V'"4 9(f -TH& vjock 40-t 3 i TP-Acl- W5, 0 PIPOF,-T Q14 ITS 2 tI ADDRESS Zoz ROAD'! IDT'li F R 0 N T-,-52�DJ-' IF L A X I N G COMMFNTS REVIEWED,13