2002, 06-26 Permit App: 02005255 ShopDi(
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509- 477 -3675
Project Description:
TYPE OF APPLICATION
ad Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New /Change)
❑ Other
SPECIFIC SITE INFORMATION
Street Address: I No O(o E I? l i d to r, a
❑ Applicant:
Phone:
Fax:
Assessor's Tax Parcel Number(s): 5507 y, z y0 /
Mailing Address:
Dimensions
3& V 90
Legal Description:
L. 0- / 8 /ock/ 5-i/1/ P.Sous Z,- Acidi'T'O) 7t
6.7Ff4 /p<r?cs
Finished basement sq. ft.
_
Department Use Only
❑ Architect /Engineer
Phone
Fax
Water District/Purveyor:
Sewer District/Purveyor
Road width
City, Stare Zip
S ?oK,,o1\1 f , (JA q9Z / Z
Setbacks
Front:
Lei c:
Rear:
Right:
School District:
Fire District:
Zoning
OWNER /APPLICANT INFORMATION
0 Indicate who should be contacted regarding this project
❑ Owner. Phone: q O 4 _ fo 8 i 9
K e v CU O O t G E Fax:
❑ Applicant:
Phone:
Fax:
Mailing Address:
I B (a 0G E t A tc.I W is o
Mailing Address:
Dimensions
3& V 90
City, State, Zip
Cncee aacre c ti.) A . 99o1(
City, State, Zip
Finished basement sq. ft.
_
0 Contractor Phone S3 4.--, 90 ib
TOW 4- COO 0JTrY € /D42SFax 53ei — g30
❑ Architect /Engineer
Phone
Fax
Mailing address
5 918 C Tire O T
Mailing address
Heat source (electric, gas, etc.)
City, Stare Zip
S ?oK,,o1\1 f , (JA q9Z / Z
City, . tate Lip
WA State Contractor license #
Tow s/ C 6 I /Z 3 C'
Contact name:
PROJECT INFORMATION
Building Information
Building height to peak
/5
# of stories
/
Main floor sq. h.
Unfinished basement sq. it.
Dimensions
3& V 90
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft.
_
Occupancy group
Construction type
Garage sq. ft.
/2 O O
Deck sq. ft.
Cost of project
Heat source (electric, gas, etc.)
Manufactured Home
Width:
Length:
Sign
What is the square footage of the sign How high is the sign?
face?
Year:
Make:
# of signs
Area of existing signs
Relocation
Fire Safety
Firm Name
Previous address
Fire Sprinkler _
Paint booth Fire Alum
Tent
Fiiieworks display
_
Inspectors:
Proposed use
Value
Are critical or hazardous materials used or stored on site?
0 Yes 0 No
Special Inspections Required?
Non- Residential Energy Code Compliance?
Firm Name
What is the current use of this proper,
Phone
Will the site be served by a septic system J Yes J No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation ^n a,.. • r'mert•: ?
l , es No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( --------%) 0 Yes I No
Are critical or hazardous materials used or stored on site?
0 Yes 0 No
Address
Inspector
Phone
0 Concrete
0 Welding
0 Bolting
0 Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? El Yes O No
If yes, identify on site plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a si:oreline?
If yes, identify on site plan 0 Ye tZt No
What is the current use of this proper,
Is your property in a designated wildlife habitat area?
O Don't know 0 Yes 15,No
Will the site be served by a septic system J Yes J No
Is any part of the property within a 100 yr flood plain?
If yes, identify on site plan
0 Maybe 0 Don't know 0 Yes CrNo
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes QJ No
Are there any wetlands, streams or ponds within 203 feet of the
property?
If yes, identify on site plan 0 Yes 21 No
Is there evidence of fill or excavation ^n a,.. • r'mert•: ?
l , es No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( --------%) 0 Yes I No
Are critical or hazardous materials used or stored on site?
0 Yes 0 No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
OYes ONo
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA?
0 Yes O No
O Yes O No
Is public water available to the site? O Yes O No
Is the property inside the PSSA?
O Yes 10 No
Is the property located within 1000 feet of a Natural Resource
Area? O Yes O No
Date Received:
Staff Representative:
Project Number: 02005255 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/26/02 Page 1 of 2
Project Information:
Permit Use: SHOP (30 X 40) Contact: TOWN & COUNTRY BUILDERS
Address: 5918 E TRENT
C - S - Z: SPOKANE, WA 99003
Setbacks: Front Left: Right: 5 Rear: 5 Phone: (509) 535-9016
Group Name:
Site Information: Project Name:
Plat Key: 003096 Name: SIMPSON'S ADD TO GREENACRES District:
Parcel Number: 55074.2401 Block: Lot:
Site Address: 18606 E BALDWIN AVE
GREENACRES, WA 99016
Location:: GRE
Zoning- UR-3.5
Water District:
Urban Residential 3.5
Owner: Name: DOEGE, KEVIN
Address: 18606 E BALDWIN AVE
GREENACRES, WA 99016
Hold: 0
Area: 0 Sq Ft Width: 98 Depth: 210 Right Of Way (ft): 50
Nbr of Bldgs: 2 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
Septic S stem Review
Permits:
Operator: JAS Printed By: JAS
Releas
Released By:
Released By:
Print Date: 6/26/02
Project Number: 02005255
Contractor:
Address: 5918 E TRENT AVE
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/26/02 Page 2 of 2
Building Permit
TOWN & COUNTRY BUILDERS Firm: TOWN & COUNTRY BUILDERS IN
Phone: (509) 535 -9016
SPOKANE, WA 99212
Const Category: New
Nbr Of Dwellings:
Bldg W x D: 30 x
Req Parking:
Description
STORAGE
Building Characteristics
Group: U -1 Type: VN
Occupant Load: Building Height: 15
40 Building Sq Ft: 1200 Sprinklers: ❑
Handicap Parking: Critical Materials: 0
This Application:
Type Notes Sq Ft Valuation
VN 1,200 $14,400.00
Totals: 1,200 $14,400.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Grp
U -1
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:
Payment Summary:
Permit Type
Building Permit
Permit Total Fees:
Fee Amount Invoice Amount
$279.61
$279.61
$279.61 $279.61
Stories: 1
Total Project:
Sq Ft Valuation
1,200 $14,400.00
1,200 $14,400.00
Fee Amount
$225.50
$4.50
$49.61
$279.61
Amount Paid
$0.00
$0.00
Amount Owing
$279.61
$279.61
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:
6/26/02
CT '
CI
Reins • .
FUP
SPOKANE COUNTY HEALTH DISTRICT
West 1101 College Avenue
Spokane, Washington 99201
456 -6040
APPLICATION TO INSTALL OR RECONSTRUCT ON -SITE SEWAGE DISPOSAL SYSTEMS
X12053
Date /� > .� Application No.
Register No.$60
Legal At k ,g,
Stitt S O� Address ' 7 jj Ad ess /Legal ,�-
phone t)1;- ��� I Description Zf
Type of
of Use l %)c r E ►1 1/4- PES, Bedrooms
f r i V
'& L� kj / N
•
Water Supply: Public (Name) Lfx .
Replacement? Yes
Septic Tank
Drainfield
Bldg. Sewer
Basement?
Side Sewer Connection t
Public System? Name of
System?
or Private Source
Drywell? Yes
Replacement? Yes
Septic Tank Length of
Capacity te° Gals. Dispersal Piping l `3 0 Ft.
Other
No Drywell
No Capacity -N,l) Gals.
Bldg )/ Sewer Elevation:
�_ Ft. Below Finished Grade
Flow /Day Gals.
Management No. of No. of
Systems? Yes No Acres Dwelling Units Mgt. Name
Ob
FEES PD: (QO Application Permit Reinsp. Bldg. Codes Release,
REMARKS:
(Date)
Application
Permit Mailing-
Address
Application Approval /Date
Installation
Permit: Issued
Installation
Approved By
of owner or au orized represent
/Aotwering.W,
e of owner's interest)
Phone
Expiration Date
Installer
S HD -ENV -002 (Rev. 3/79)
Date
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