2002, 06-19 Permit App: 02004947 Residence to AFHProject Number: 02004947
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: CHANGE OF USE -RESIDENCE TO ADULT
FAMILY HOME
Date: 6/19/02 Page 1 of 2
Setbacks: Front Left:
Right: Rear:
Site Information:
Plat Key: 001220 Name: HILLCREST PARK ADD
Parcel Number: 45272.0908 Block:
SiteAddress: 1807 S COLLINS RD
SPOKANE, WA 99216
Location:: SPO
Zoning: UR -7
Water District:
Area: 0 Sq Ft
Nbr of Bldgs: 1
Review Information:
Review
Plan Review
Permits:
Contractor: OWNER
Urban Residential -7
Width: 90
Nbr of Dwellings: 1
Originally Released:
Contact: CARL BURGESS
Address: 1311 E 18TH AVE
C - S - Z: SPOKANE WA 99203
Phone: (509) 701-1757
Group Name:
Project Name:
Lot:
Owner: Name:
Address:
District: F
HAUGE, RUDOLF
1108 ROSEMARY DR
WICHITA FALLS TX 76306
Hold: 0
Depth: 140 Right Of Way (ft): 0
I Released By:
6/19/02 By: jshatto
Building Permit
Firm: OWNER
Phone:
Building Characteristics
Const Category: Change Of Use Group: LC -1 Type: VN
Nbr Of Dwellings: Occupant Load: 5 Building Height:
Bldg W x D: x Building Sq Ft: Sprinklers: El
Req Parking: Handicap Parking: Critical Materials: 0
Item Description
CHANGE OF USE/SAFETY INSP
STATE SURCHARGE
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
Operator: JAS Printed By: JAS
Stories:
Fee Amount
$50.00
$4.50
Permit Total Fees: $54.50
Print Date:
6/19/02
Project Number: 02004947 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/19/02 Page 2 of 2
Notes:
APPROVED FOR (3) GROUND FLOOR AND (1) 2ND FLOOR SLEEPING ROOMS FOR (5)
TENANTS WITH CLASS I EVACUATION CAPABILITY
Payment Summary:
Permit Type
Building Permit
Fee Amount
$54.50
$54.50
Invoice Amount
$54.50
$54.50
Amount Paid
$0.00
$0.00
Amount Owing
$54.50
$54.50
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 contrued 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: JAS Printed By: JAS
Print Date: 6/19/02
1111
SPOMNJ CouwY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Street Address:
to J. Co///r,s
SPECIFIC SITE INFORMATION
pn/Ccs# e , ,-
Assessor's Tax Parcel Number(s):
`iS2�2,D40e
Legal Description:
fr
1
Project Description:
0 Building Permit
0 Relocation
o Aotu/¢ /=am.�/r h�ow+e
O�Changc in Use
0 Grading
0 Manufactured Home Permit
0 Sign
Department Use Only
Water Districr/Pun•eyoc
School District.
0 Tenant (New/Change)
0 Other
Seaver District/Purveyor
Road- idth
Fire District.
Zoning A_
Rear.
Right
OWNER/APPLICANT INFORMATION
21!,zd:oi a•h., .F,.' I' i...onia t�rd t/u:
-1/S
Phonr4 3S-Z3AP
i2i ei J f fl e- Fax: 534 —
Mailing Address:
Mailing adJress
City,.Gare Zip
Irax
Phone
Atading aJdress
Fax
\C q State Contractor licensa
City, Sutc• "Lip
Contact name:
PROJECT INFORMATION
Building height u, peak
254' //
Ct-1 (34-
(>ccupancy gn,u f,
cost of prt leer
Building Information
tt .,f Stt,rie
Main (kit's -sq. It.
.1.Hal habitable :race 2 ' floor sy_ ft.
2,,F ! 9 to C!
C=onstruction nro Garage sq. ft.
G fiiP .7G
11eat source (electric_ gas_ etc.)
r,4 G -/ Aip-4
Untirrished basa-mrnt sq. fl_
Finished basement sq. ft.
Deck sq. fr.
//�
Manufactured Home
Width:
Length:
S
Make:
# of signs
Relocation
Previous address
Proposed use
How high is the sign?
Area of existing signs
Fire Safety
Fire Sprinkler
Paint booth _ Fire Alarm
Tent
Fireworks display
Value
Special .Inspections Required?
Firm Name
Phone
Inspectors:
I Non -Residential Energy Code Compliance?
Plans Examiner Phone
O Concrete O Welding 0 Bolting 0 Reinforcement
Address
Inspector
Address
Phone
ADDITIONAL SITE INFORMATION
Are there �s��tructures on the property? LA'Ycs 0 No
fyes, idellt5! on _ire plon
1s any part of the property .within 250 feet of a shoreline?
Ifyes, ident,ifr on site plan 0 Yes lAt...r\10
Is your property in a designated wildlife habitat arca?�,�
0 Don't know 0 Yes Ike No
Is any part of the property within a 100 yr flood plain?
fyrs, ideert on site plan
0 Maybe 0 Don't know 0 \'cs L!T No
Are there any wetlands_ streams or ponds within 200 f51, -t of the property?
s, aeon on site plan 0 Yes ®/No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
0 Yes
t?iNo
\Y•hat is the current property size?
(square feet or acres)
What is the current use of this property?
\XIII the site be served by a septic system? erYes 0 No
.‘re or will there be wells heated on the property?�
Jf yes, rami on rhe site plan 0 Yes o
Is there evidence of fill or excavation on the property?
0 Ycs ' No
Are critical or hazardous materials used or stored on sire?
0 Ycs l No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
Is public sewer available to the site?
0 Yes 0 No
Is the property inside the ASA?
Is the property inside the PSSA?
Dvc Received:
0 Yes 0 No
0 Yes
0 Ycs
O,Yes
I,earl Reprevntativs-
O No
O No
O No
Is public water available to the site?
0 Yes 0 No
Is the property located within 1000 feet of a Natural Resource Area?
O Ycs 0 No
METHOD OF PAYMENT
❑ (._\SII ❑ (:1I1,cl: [] _VISA
®
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
I) VI1 is FAPIRI-:S:
I3.\NI:C.\RI) Tll'\1I3ER:
.\llItIORI%(I) SIGN.\l1IRt..
sIBT(YI'.u.
TOTAL FEE
M/N/MrJM
PERMIT FEE IS S3500 PLEASE
MAKE CI a:cKs P5YAISLE TO SPOKANE
(.t )lN1 V PERMIT CENTER
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EMERGE jCV EGRESS REQUIRMENTS
0
t I NET CLEAR OPENING - 5.7 SQUARE FEET
21 NET CLEAR OPENING HEIGHT- 24 INCHES
31 NET CLEAR OPENING WIDTH - 20 INCHES
4, FINISHED SILL HEIGHT - 44 INCHES ABOVE
FLOOR MAXI
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