2001, 06-27 Permit App: 01005160 Addition Project Number: 01005160 Inv: 1Application Date: 6/27/01 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-LIVING RM,DINING Contact: CUSTOM INTERIORS
RM,SUN PORCH Address: 3527 E SPRAGUE#7
C-S-Z: SPOKANE,WA 99202
Setbacks:Front 48 Left: NA Right: 12 Rear: 30+ Phone: (509)533-0176
Group Name:
Site Information: Project Name:
Plat Key: 999999 Name: RANGE District: F
Parcel Number: 45241.9029 Block: Lot:
SiteAddress: 17010 E 4TH AVE Owner:Name: ROUNSVILLE,DALE L
GREENACRES,WA 99016 Address: 17010 E 4TH AVE
Location::GRE GREENACRES,WA 99016
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 0 Sq Ft Width: 99 Depth: 440 Right Of Way(ft): 50
Nbr of Bldgs: 3 Nbr of Dwellings: 1
Review Information: ,
Department Review
BUILDING Site Plan Review
Released By. AgA JAXitif
Hold Reasons:
Permit Conditions:
BUILDING Plan Review [Released By: ► '� ` a
Hold Reasons:
Permit Conditions:
HEALTHDISTRICT Septic System Review /
Released By:
t+ Hold Reasons: fy
Permit Conditions:
Permits: .
Project Number: 01005160 Inv: 1 Application Date: 6/27/01 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit _Contractor: CUSTOM INTERIORS&CONST Firm: CUSTOM INTERIORS&CONST
Address: 3527 E SPRAGUE#7 Phone: (509)533-0176
SPOKANE,WA 99202
Building Characteristics
Const Category: Addition Group:R-3 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height: 16 Stories: 1
Bldg W x D: 6 x 30 Building Sq Ft: 180 Sprinklers: 111
Req Parking: Handicap Parking: Critical Materials: L
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RES ADD R-3 VN 180 $11,160.00 180 $11,160.00
Totals: 180 $11,160.00 180 $11,160.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $188.00
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $41.36
Permit Total Fees: $233.86
Payment Summary:
Operator: CKF Printed By: CKF Print Date: 6/27/01
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $233.86 $233.86 $0.00 $233.86
$233.86 $233.86 $0.00 $233.86
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
509-477-3675
SPOxA COUNTY
SPECIFIC SITE INFORMATION
Street Address:
70 i 0 %, 4f7-4
Assessor's Tax Parcel Number(s):
Legal Description: ({>✓S C 06-IVi- pre_ i9-.0Or 7-I 0 tv
Project Description: R E9E0 F N7i4-6- 04-DDI T/6/V
Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
El Relocation ❑ Sign ❑ Tenant(New/Change) ❑ Other
Department Use Only
Water District/Purveyor. Sewer District/Purveyor Road width Setbacks
Front Rear.
School District Fire District: Zoning
Left. Right:
OWNER/APPLICANT INFORMATION
t Indicate who should be ontacted renpardin,;this jsr jets
Ga Owner: Phone: 9 2-�— 6c6 p ❑ Applicant: Phone:
046E OUMD Fax: I as.
Mailing Address: Mailing Address:
/7Ol0 G its
(:its,State,Zip City,State,/ip
5 P d r1#^C W 4.
® Phone rhone 7 6 ❑ Architect i 1-:n},nnecr Phone
GUSid M JMrE4 .ok'S Fax Fax
Mailing address Mailing address
55-27 E. 5PRA-6v ' '7
Ciao,State/ip Can.,State lip
5-P0 k4- 4 . 9ci? o 2-
AA
VA rA State Contractor license# Contact name.
C &$T0 ic 03,01' 7
PROJECT INFORMATION
Building Information
Building height to peak #of stories Nlain floor sg.ft. Unfinished basement sq.ft.
(61 f 751J
Dimcnsritns - Total habitable space 2"1 floor sg.ft. Finished basement sq.ft.
4,drsokrao-o s3
Occupancy group Construction type Garage sg.ft. Duck sg. ft.
Cost of project I feat source(electric,gas,etc.)
( I
Manufactured Home Sign
Width: Length: What is the square footage of the sign I low high is the sign?
face?
Year: Make: #of signs Arca 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?
Firm Name Phone Plans Examiner Phone
Inspectors: Address
Inspector Phone
0 Concrete O Welding O Bolting 0 Reinforcement Address
ADDITIONAL SITE INFORMATION
Arc there structures on the property? Yes O No What is the current property size?
Ifyes,identify on site plan (square feet or acres)
Is any part of the property within 250 feet of a shoal.se? What is the current use of this property?
If yes,identify on site plan 0 Yes No
Is your property in a designated wildlife habitat a ea? _ Will the site be served by a septic system?)<Yes 0 No
0 Don't know 0 YesNo
Is any part of the property within a 100 yr Hood pla n? \re or will there be wells located on the property?
Ifyes,yes,identi6Y au site plan Ifyes,hes,ident j,on the site plan 0 Yes 0 No
0 Maybe 0 Don't know 0 Yes 0 No
Are there any wetlands,streams or ponds within 900 feet of the property? Is there evidence of till or excavation on the property?
Ifyes,ideate on site plan 0 Yes No 0 Ycs 0 No
Arc there slopes greater than 30°0 on the property?(30 ft se in 100 ft) Are critical or hazardous materials used or stored on site?
/"o) O Yes No O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? 0 Yes O No
Ycs 0 No
Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No
DYes 0N
Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area?
D Yes O No
Date Received: Staff Representative:
METHOD OF PAYMENT
VISA t€IC•VC" SUB1(fl.A1,
❑ CASII ❑ CIIF(;K 0 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
TOTAL FEE
B.ANKC.ARD NUiNIBI:R_ MINIMUM PERMIT FEE IS$35.00 PLEASE
:MAKE CHECKS PAYABLE TO sPoN.AAE
AP 11 IORI/1:D SIGN:ATURI?: caey'rY PERMIT CENTER
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