2001, 03-26 Permit App: 01001795 AdditionAll ,
Project Number: 01001795 Inv: 1 Application Date: 3/26/01 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Permit Use: 2 STORY ADD TO RESIDENCE - REC ROOM,
Contact: ERDEM, RACI
UTILITY ROOM MASTER BED & BAT
Address: 1719 S BURNS RD
C - S - Z: VERADALE, WA 99037
Setbacks: Front EXI Left: 24 Right: 16 Rear: 20+
Phone: (509) 892-1395
Group Name:
Site Information:
Project Name:
a�
Plat Key: 003474 Name: JAN'S ADD
District: F
Parcel Number: 45261.2814 Block:
Lot:
SiteAddress: 1719 S BURNS RD Owner: Name: ERDEM, RACI
VERADALE, WA 99037
Address: 1719 S BURNS RD
Location:: VER
VERADALE, WA 99037
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Hold: ❑
Area: 0 Sq Ft Width: 93
Depth: 165 Right Of Way (ft): 50
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Department Review
BUILDING Site Plan Review
e - -
TT
Hold Reasons:
Permit Conditions:
BUILDING Plan Reviewl
Released By:
asons: e OLD
�_
_
Permit Conditions:
Permits: -
1k
Project Number: 01001795 Inv: 1 Application Date: 3/26/01
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: Addition Group: R-3 Type: VN
Nbr Of Dwellings: 1 Occupant Load:
0 Building Height: 20
Stories:
17
Bldg W x D: 2 x 25 Building Sq Ft:
965 Sprinklers: El
Req Parking: 0 Handicap Parking:
0 Critical Materials: ❑
This Application:
Total
Project:
Description Grp Type Notes
Scl Ft Valuation
SSC Ft
Valuation
2ND FLOOR R-3 VN
425 $26,350.00
425
$26,350.00
DECK R-3 VN
451 $3,319.36
451
$3,319.36
RES ADD R-3 VN
340 $21,080.00
340
$21,080.00
Totals:
1,216 $50,749.36
1,216
$50,749.36
Item Description Units
Unit Desc
Fee Amount
RESIDENTIAL VALUATION 1
Y OR BLANK
$586.25
STATE SURCHARGE 1
Y OR BLANK
$4.50
RESIDENTIAL SURCHARGE 1
Y OR BLANK
$128.98
Permit Total Fees:
$719.73
Mechanical Permit
Contractor: OWNER Firm: OWNER
Address: 0 Phone: (000) 000-0000
000000, 00 000000
Item Description
DUCT SYSTEMS
VENTILATING FANS
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
TOILETS/BIDETS
SINKS
TUBS
CLOTHES WASHER
Units Unit Desc Fee Amount
1 NUMBER OF $10.00
3 NUMBER OF $30.00
Permit Total Fees: $40.00
Plumbing Permit
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc Fee Amount
2 NUMBER OF $12.00
3 NUMBER OF $18.00
1 NUMBER OF $6.00
1 NUMBER OF $6.00
Permit Total Fees: $42.00
Page 2 of 3
Project Number: 01001795 Inv: IApplication Date: 3/26/01 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summa
Operator: RMB
Printed By: RMB
Print Date:
3/26/01
Permit Type
Fee Amount Invoice Amount
Amount Paid
Amount Owing
Building Permit
$719.73
$719.73
$0.00
$719.73
Mechanical Permit
$40.00
$40.00
$0.00
$40.00
Plumbing Permit
$42.00
$42.00
$0.00
$42.00
$801.73
$801.73
$0.00
$801.73
Notes:_AW,
MN __....
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
"Awn -9 SPOKANE, WA 99260
SPOKE COUNrY 509-477-3675
SPECIFIC SITE INFORMATION
Street Address: i
.7 1 A S,- �X A
Assessor's Tax Parcel Number(s):
Legal Description: ;[ j 1
L45
Project Description:
' A C"Ac-t-- ' -6c—
cn
Setbacks"
E (- ^
,,3
Front: Rear:
sch,jol DISSI ICC
Fire District: Zoning
Fax:
`--' ' t- - ,
uilding Permit
Mailing Address:
( -1 1 ck S n �— 'v �- 1� - �.5
❑ Change in Use
Mailing Address:
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
5 I
❑ Sign
City, State, Zip `
t C\ �,t. \ <- "'
I ❑ Tenant (New/Chance)
I ❑ Other
1 00104!Dep artment Us_.e Onl
Water Disnio/Purvcyoc
Sewer District/Poiveyor Roadwidth
Setbacks"
E (- ^
,,3
Front: Rear:
sch,jol DISSI ICC
Fire District: Zoning
Fax:
`--' ' t- - ,
left: Right:
OWNER/APPLICANT INFORMATION
IBJ /ndiraro vohn shnuld by rn t -t d -ii.. erne n -,.-t
Ckvner:
Phone: CkZ ^ 3 O'
❑ Applicant:
Phone:
E (- ^
,,3
e `
�
of stories
U L -A- .
Fax:
`--' ' t- - ,
Fax:
Mailing Address:
( -1 1 ck S n �— 'v �- 1� - �.5
J
Mailing Address:
ha/bjtab�e space
2"d floors . ft.
C
5 I
b
City, State, Zip `
t C\ �,t. \ <- "'
IV
City, State, Zip
on tr ctign type
❑ Contractor
r L
L
Phone (. C,.
�rj `S
❑ Architect/Engineer
Phone 2� -�.. 1 q ..
l
l
Fax
\ -C��'
Fax
Mailing address
C-1 C-. ).
Mailing address
so'---
1. -
City, State Zip
City, State Zip
t t�
o >v. \ 3 0
WA State Contractor license X
Contact name:
PR01FCT TNFC)RMATTON
Building Information Y
Building height to peakN
�
of stories
Main floors . ft.
Unfinished,ITas nt sq. ft.
2
3 o
J
Diin cionsTotal
ha/bjtab�e space
2"d floors . ft.
Finished u�as'emgnt sq. ft.
5 I
b
2
IV
Occupancy group
on tr ctign type
Garage sq. ft.-
Deck sq. ft., r
Cost of roject
Heat source (electric, gas, etc.)
''0-9 0
C-1 C-. ).
Manufactured Home
Width:
Length: What is the square footage of the sign
face?
I Iow high is the sign?
Year:
Paint booth Fire Alarm Fireworks display
Make: N of signs
Area of existing signs
L7
WIM the site be ed by a septic system? O Yes No
Inspector
Special Inspections Required?
Non -Residential Energy
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
Is your property in a designated wildlife habitat area?
WIM the site be ed by a septic system? O Yes No
Inspector
Phone
O Concrete O Welding O Bolting O Reinforcement
Address
If yes, identify on site plan
ADDITIONAL. SITF. INFORMATION
Are there structures on the pro erty? Yes O No
What is the current property size?
I yes, identify onsite plan
(square feet or acres
Is any part of the property within 250 feet ashoreline?
What is the current use of thi property?
I es, identify on site plan O • Yes No
�: I11,k,o`
Is your property in a designated wildlife habitat area?
WIM the site be ed by a septic system? O Yes No
O Don't know (73 Yes No
Is the property inside the PSSA?
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, identify on the site plan O Yes No
O Maybe O Don't know O Yes No
Are there any wetlands, streams or ponds within 200 feet of the
Is there evidence of fill or excavation on the property)
A
property?
O Yes No
1 yes, identily on site plan O Yes XN0
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
O Yes No
I>EPAR'l'NIFN'I' USF ONLY
Is ilio property in a designated Stormwater Control Area? _ -,
Is public sewer available to the site? O Yes " l7 No,
TOTAL FEE
O Yes D No
MINIM tiny PERMUFee JS$35.00 PL.FASE
Is the property inside the ASA?
D Yes O No
Is public water available to the Site? O Ycs D No
COUNTY -FERMI r CENTER -
11 Yes O No
Is the property inside the PSSA?
O Yes D No -
Is the property located within 10001eet of a Natural,Resource Area?
O Yes O No
Date Recety d: Staff Representative:
0sj2y jo r
METHOD OF PAYMENT
CASH El CHECK [jY/SA ❑ _ ❑
FAXED PERMITS WILL ONLY BE ACEPTED Will] PAYMENT OF A MAJOR CREDIT CARD
DATE: —_-- EXPIRES:—
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL
TOTAL FEE
MINIM tiny PERMUFee JS$35.00 PL.FASE
MAFiE U IIiCKS PAYABLE. TO SPOKANE
COUNTY -FERMI r CENTER -
kit
This site plan is being submitted for the purpose o
obtaining a building permit and is a true and corre
representation of the proposal. All known propert!
linesidimensions, cu s. structures and ease
have been identi I indicated are wetlands
bodieIGfwat�e�/ opes or other critical areSigne—�--
Date.