2001, 12-20 Permit App: 01010992 Partial Basement FinishProject Number: 01010992 Inv: 1
Application Date: 12/20/01 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: PARTIAL BASEMENT FINISH - BATHRM,
BEDRM FAM FM, SEWING RM
Setbacks: Front
Left: Right: Rear:
Site Information:
.
Plat Key: 005914 Name: DHAENENS SQUARE PHASE II
Contact: JIM LABENNE /J L CONST
Address: 15626 N MCKINNEN RD
C - S - Z: MEAD, WA 99021
Phone: (509) 466 -6111
Group Name:
Project Name:
District: F
Parcel Number: 45224.4104 Block:
SiteAddress: 1417 S AVALON LN
Spokane, WA USA 99216
Location:: SPO
Zoning: UR -7 Urban Residential -7
Water District: 010 VERA
Area: 4,518 Sq Ft Width: 58
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Lot:
Owner: Name: STONE, NANCY
Address: 1417 S AVALON LN
SPOKANE, WA 99216
Hold: ❑
Depth: 90 Right Of Way (ft): 30
rr . ,,_. -ww
Review
Plan Review
Permits:
Released By:
Operator: CKF Printed By: Print Date:
Project Number: 01010992 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/20/01 Page 2 of 2
Building Permit
Contractor: J L CONSTRUCTION Firm: JIM LABENNE /J L CONSTRUCTIO
Address: 15626 N MCKINNON RD Phone: (509) 466 -6111
MEAD, WA 99021
Const Category: Remodel
Building Characteristics
Group: R -3 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: 980 Sprinklers: ri
Req Parking: Handicap Parking: Critical Materials: D
This Application: Total Project:
Description Grp Type Notes Su Ft Valuation Sq Ft Valuation
BASEMENT R R -3 VN 980 $15,444.80 980 $15,444.80
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:
OK TO ISSUE SEWER PERMITS FOR BLOCK 1 - LOTS 1 TH 10, BLOCK 2 - LOTS 1 TH 12 PER
ROGER 10/23/98
DO NOT ISSUE SEWER PERMITS FOR BLOCK 3 - LOTS 1 TH 7, BLOCK 4 - LOTS 1 TH 5,
BLOCK 5 - LOTS 1 TH 6
Totals: 980 $15,444.80 980 $15,444.80
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Fee Amount
$238.00
$4.50
$52.36
$294.86
Payment Summary:._,,
Permit Type
Building Permit
Fee Amount
$294.86
$294.86
Invoice Amount
$294.86
$294.86
Amount Paid Amount Owing
$0.00 $294.86
$0.00 $294.86
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 (aws or ordinances.
Signature:
Operator: CKF Printed By: Print Date:
SPOK COUNTY
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:
Assessor's Tax Parcel Number(s):
/'-i /7
"j 11,iLc //
Legal Description:
Project Description: u%S r/
{Building Permit
❑ Change in Use
❑ Grading
❑ Relocation
❑ Sign
❑ Tenant (New /Change)
❑ Manufactured Home Permit
❑ Other
Department Use Only
Water District /Purveyor:
Sewer District /Purveyor
Road width
Setbacks
Front: itcar:
Left: Right
School District:
Fire District
Zoning
OWNER /APPLICANT INFORMATION
flute who sboa/d be ontacled re nardine this broieet
❑ • er
/L4_
Building height to peak
'
Phone:
. Fax:
❑ Applicant:
/ /ti
\
'
Phone:
Fax:
Mailing Address:
/S6dCV
Ih
L�
Mailing Address:
/
1
�% /7
G"V
,
Cost of project
%
/ C,7 /'cD
Heat source (clect n
City, State, Zip Aw
"e9 At
tfr
Contractor
El Contractor
•
/ C-'
�
Fax
❑ Architect/Engineer
St
Phone
Fax
Mailing address
ity, tate Zip
ri �-3
!FY
dad /
City, State Zip
WA State Contractor li ense #
Contact name:
ECT INFORMATION
Building Information
Building height to peak
'
# of stories
/
Main Floor sq. ft.
Unfinished basement sq. ft.
3o/
Dimensions
Total habitable space
2'ut floor sq. ft.
finished basement sq. ft.
Occupancy group
Construction
S`' /cif //1.103.0117:--
Garage sq. ft.
Deck sq. ft.
Cost of project
%
/ C,7 /'cD
Heat source (clect n
ns tc.)
Manufactured Home
Sign
Width:
Length:
What is the square footage of the sign
face?
Flow high is the sign?
Year:
Make:
# of signs
Area of existing signs
Fireworks display
. \re critical or hazardous materials used or stored on site?
O Yes O No
;Address
Proposed use
Relocation
Fire Safety
IAirm Name
What is the current use of this property?
Previous address
Will the site be served by a septic system? O Ycs O No
Paint booth
Fire Sprinkler
Tent
Fire Alarm
Fireworks display
. \re critical or hazardous materials used or stored on site?
O Yes O No
;Address
Proposed use
Value
Special Inspections Required?
Non - Residential Energy Code Compliance?
IAirm Name
What is the current use of this property?
Phone
Will the site be served by a septic system? O Ycs O No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
El Yes O No
.\rc there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( — %) O Yes O No
. \re critical or hazardous materials used or stored on site?
O Yes O No
;Address
Inspector
Phone
0 Concrete
0 Welding
0 Bolting
0 Reinforcement
1ddress
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes O No
Ifyes, ideitti 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?
Ifyes, identj 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 Ycs O No
Is any part of the property within a 100 yr flood plain?
Ifyes, ident5' on site plan
O Maybe O Don't know O Ycs D No
.1re or will there be wells located on the property?
Ifyes, ident j, on the site plan O Yes O No
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifyes, identi on site plan O Yes O No
Is there evidence of fill or excavation on the property?
El Yes O No
.\rc there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( — %) O Yes O No
. \re critical or hazardous materials used or stored on site?
O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
O Yes
O No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA?
0 Yes
O Yes
0 No
D No
Is public water available to the site? 0 Yes 0 No
Is the property inside the PSSA?
0 Yes
0 No
Is the property located within 1000 feet of a Natural Resource Area?
OYes ONo
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ CASII ❑ CHECK ❑ MEM= ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
EXPIRES:
BANKCARD NUMBER:
AUTHORV.ED SIGNATURE:
SUBTOTAL.
TOTAL FEE
MINIMUM PERMIT FEE IS $35.A0PLEASE
\t \KE CI1ECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER