2001, 01-02 Permit App: 01000020 Remodel ,
Project Number: 01000020 Inv: 1 Application Date: 1/2/01 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: FINISH(2)BEDROOMS,REC ROOM, Contact: MORAN,DAVID
BATHROOM,&STORAGE IN BASEMENT Address: 19002 E 4TH AVE
C-S-Z: GREENACRES,WA 99016
Setbacks: Front Left: Right: Rear: Phone: (509)927-0821
Group Name:
Site Information: Project Name:
Plat Key: 000498 Name: CORBIN ADD TO GREENACRES District: G
Parcel Number: 55202.0225 Block: Lot:
SiteAddress: 19002 E 4TH AVE Owner:Name: MORAN,DAVID
GREENACRES,WA 99016 Address: 19002 E 4TH AVE
Location::GRE GREENACRES,WA 99016
Zoning: UNKN Unknown
Water District: Hold: ❑
Area: 0 Sq Ft Width: 183 Depth: 185 Right Of Way(ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Department Review
BUILDING Plan Review ! r
Releases . ,: I t��j�l
Hold Reasons:
rmit Co d tions:
VTAllek
..41_,\____
H ALTHDI'yi RICT Sep 'c System 'eview
rr I Released By: �. t Z
Hold Reasons:
Sewage system designpd — --- -- ---
Permit Conditions: for3 bedrooms only.
Perm its: �,
r � �
Project Number: 01000020 Inv: 1 Application Date: 1/2/01 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
Address: 0 Phone: (000)000-0000
000000,00 000000
Building Characteristics
Const Category: Remodel Group:R-3 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: El
Req Parking: Handicap Parking: Critical Materials: II
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT F R-3 VN REMODEL 0 $3,000.00 0 $3,000.00
Totals: 0 $3,000.00 0 $3,000.00
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
Mechanical Permit
Contractor: OWNER Firm: OWNER
Address: 0 Phone: (000)000-0000
000000,00 000000
Item Description Units Unit Desc Fee Amount
VENTILATING FANS 1 NUMBER OF $10.00
MINIMUM FEE ADJUSTMENT 1 Select $25.00
Permit Total Fees: $35.00
Plumbing Permit — —
Contractor: OWNER Firm: OWNER
Address: 0 Phone: (000)000-0000
000000,00 000000
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 1 NUMBER OF $6.00
SINKS 1 NUMBER OF $6.00
SHOWERS 1 NUMBER OF $6.00
MINIMUM FEE ADJUSTMENT 1 Select $17.00
Permit Total Fees: $35.00
Project Number: 01000020 Inv: 1 Application Date: 1/2/01 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary:
Operator: JAS Printed By: JAS Print Date: 1/2/01
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $96.61 $96.61 $0.00 $96.61
Mechanical Permit $35.00 $35.00 $0.00 $35.00
Plumbing Permit $35.00 $35.00 $0.00 $35.00
$166.61 $166.61 $0.00 $166.61
•
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1 . 1 PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
ill SPOKANE,WA 99260
SPOKANE COUNTY 509-477-3675
SPECIFIC SITE INFORMATION
Street Address: I -LainZ � e�� �� ,� 5 ( �'�d e
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description:
O Building Permit 0 Change in Use 0 Grading 0 Manufactured Home Permit
O Relocation 0 Sign _ 0 Tenant (New/Change) 0 Other
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y ":�"},inviastlyenwfmmaai, e''4" a die � _,
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
'CJ Owner: Phone: NZ—.1 d 8Z— ❑ Applicant: Phone:
Fax: Fax:
Mailing Address: Mailing Address:
City,State,Zip 141-
� q City,State,Zip
Cr-eE'vl &c d'� S Wc; 2 — aE3Z_(
0 Contractor Phone 0 Architect/Engineer Phone
Fax Fax
Mailing address Mailing address
City,State Zip City,State Zip
WA State Contractor license i! Contact name:
•
PROJECT INFORMATION
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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.
/
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of roject Heat source(electric,gas,etc.)
jty4, ar�s�}''�y-- p'� `� -� ;a� s€� , reatrV -t«,. 'gut - z * 4-w o-t,4,?r- �' s
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Width: Length: What is the square footage of the sign How high is the sign?
face?
Year: Make: #of signs Area of existing signs
''.`y t a .yam 'AR4 i s c ' 's� 4 '�
tga
Previous address Fire Sprinkler Tent
Paint booth Fire Alarm Fireworks display
Proposed use Value
Firm 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? O Yes O No What is the current property size?
If yes,identify on site plan (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,identify on site plan O 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? Are or will there be wells located on the property?
If yes,identify on site plan If yes,identih,on the site plan O Yes O No
O Maybe O Don't know O Yes 0 No
Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the property?
property? O Yes O No
If yes,identify on site plan O Yes O No
Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
( /%) O Yes O No O Yes O No
t �,,_ DEPARTMENT USE ONLY
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gliY � 5s •�'� X�s6 w?'v §" ia+ 'gam 4 d.£` '
Lr a3 Cd �e SK ® r s c hi .r ® iJ�,a Site 'wow,m
„ ix-'.� .1 - � 04. - € 4,7* 3 � a `i, 1 ,11 � . t wIll ...
Date Received: Staff Representative:
METHOD OF PAYMENT
MEM. ; NfC YES'
SUBTOTAL
VISA
❑ CASH ❑ CHECK ❑ ❑ Vir—4f= ; ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE: EXPIRES: Iflr4t)- v
BANKCARD NUMBER: MrlsvMUMPER�tr'PFE S$35oo3'fCA
MAKE f 17ECKSPAYAEL TCS SPO$AW
AUTHORIZED SIGNATURE: COUNTYPEttM1'TC0NTEK