2002, 05-29 Permit App: 02004154 Office RemodelI I
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SPOKE Cowry
•
PROTECT 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:
z� y q/ ii- b114
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description:
X Building Permit
0 Relocation
a r7rcle OP/ e3h�
O Change in Use
O Grading
O Manufactured Home Permit
O Sign
O Tenant (New /Change)
O Other
Depait>nent Use Only
Water INS trict /Punveror.
School District
Sewer District /Purveyor
Fire District:
OWNER /APPLICANT INFORMATION
0 ladr,v�e who char ld lx annfae7ed n. ureic, lh- - Y
Phone: 7 Zg i E.3"
cI4,c k ow, �t-- tae:
❑ Applicant:
C�,
1
/1/\w
l lv h�/
Phone: L qCe _ 79 z, 5
Fax:
?tailing Address:
7eZ /if 5Q1 (4r� /v
Mailing Address:
2nd fl or sq. ft.
Finished basement sq. ft.
Occupancy group
/ i.,
City, State, Zip
Deck sq. ft_
( :ost of project
(5-bC
Ilea' sourer (electric, gas_ rte.)
Cu xis r / �y C !�/ •, G,
o Phone i 14f'^ /74 g 3.
L1 ice C' o f 7 'w'i t0 11 n
' _
❑ Archi[ec1 /Fngincrr
Phone
Fax
Mailing address
LJ
Mailing address
I I - �0 _� V
Cite, Aare Zi
C' en f / L J,4 99 004/
City, State Zip
W . Stater actor license -
C i� -Eu9 r zQ7 kH
Contact name.
PROJECT INF
Building Information
Ruilding height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimcv ons
"final habitable space
2nd fl or sq. ft.
Finished basement sq. ft.
Occupancy group
(o mist ruction type
Garages.. ft.
Deck sq. ft_
( :ost of project
(5-bC
Ilea' sourer (electric, gas_ rte.)
Is public water available to the site? 0 Yes 0 No
Manufactured Home
Width:
Year
Length:
Sign
wit, is the square footage of the sign
face?
How high is the sign?
Make:
# of signs
Area of existing signs
Relocation
Previous address
Proposed use
Fire Safety
Fire Sprinkler —
Paint booth _ Fire Alarm
Tent
Fireworks display
Value
Special Inspections Required?
Finn Name
Inspectors:
Non - Residential Energy Code Compliance?
Phone
Plans Examiner
Phone
Address
0 Concrete 0 Welding 0 Bolting 0 Reinforcement
Inspector Phone
Address
Arc there structures on the property? 0 Yes 0 No
fyes, ide tt fr on site plan
Is any part of the property- within 250 feet of a shoreline?
fyer, ideitz on rite plan 0 Yes 0 No
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes 0 No
ADDITIONAL SITE INFORMATION
\Xhat is the current property size?
(square fret or acres)
What is the current use of this property?
Is any part of the property within a 100 yr flood plain?
IJyer, identity on cite plan
0 Maybe 0 Don't know 0 Yes 0 No
Are there any wetlands, streams or ponds within 200 feet of the property?
Ilya, , it/tilt of site plan 0 Ycs O No
Are there slopes greater than 30°°0 on the property? (30 ft rise in 100 ft)
0 Yes 0 No
\Xill the site be served by a septic system? 0 Yes 0 No
Are or will there be wells located on the property?
If yes.
identifi, on the site plan 0 Yes 0 No
Is there evidence of fill or excavation on the property?
O Yes 0 No
Are critical or hazardous materials used or stored on site?
O Ycs ONo
Is the property in a designated Stormwater Control Area?
O Yes O No
DEPARTMENT USE ONLY
Is the property inside the ASA?
Is public sewer available to the site? 0 Yes 0 No
O Yes O No
O Yes 0 No
Is the property inside the PSSA? O .Yes 0 No
Dare Received: 1 :tartticprrxcntui . e:
Is the property located within 1000 feet of a Natural Resource Area?
O Yes 0 No
METHOD OF PAYMENT
O
❑ C \SII ❑ (;III:C: ❑ ❑
trE
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
1):\'1•:=
EXPIRES:
S:
B. \NKC. \RI) NUMBER:
\U7 F K)RI' /J I) SIGNATURE:
SIAM )1A1.
TOTAL FEE
MINIMUM PERMIT FEE IS $35. 00 PLEASE
NIA kV. CI IECIS PAYABLE TO SPOKANE
COGN7Y PERMIT C.EN7tiR
Project Number: 02004154 Inv: 1
t �ppli- cation
Date: 5/29/2002 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
.................. ...............................
................. ...............................
Permit Use: HOME OFFICE REMODEL
Setbacks: Front Left: Right: Rear:
Site Information:
Plat Key: 000382 Name: CHESTER HILLS ADD.
Contact: C. KEEVYS REMODELING
Address: S 13202 GOSS RD
C - S - Z: CHENEY, WA 99004
Phone: (509) 999 -4631
Group Name:
Project Name:
District:
F
Parcel Number: 45291.0706 Block:
SiteAddress: 2024 S BALFOUR BLV
SPOKANE, WA 99206
Location:: SPO
Zoning: UR 3.5
Water District:
Urban Residential 3.5
Lot:
Owner: Name: SWIFT, CHUCK & DONNA
Address: 2024 S BALFOUR BLV
SPOKANE, WA 99206
Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Review
Plan Review
Permits:
Operator: RMB Printed By: RMB
Print Date: 5/29/2002
Project Number: 02004154 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/29/2002 Page 2 of 2
Building Permit
Contractor: CRAIG KEEVY REMODELING Firm: CRAIG KEEVY REMODELING
Address: 13202 S GOSS RD Phone: (509) 448 -7423
CHENEY, WA 99004
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: 0
Req Parking: Handicap Parking: Critical Materials: 0
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RESIDENCE R -3 VN REMODEL 0 $5,000.00 0 $5,000.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:
Payment Summary
Permit Type
Building Permit
Totals: 0 $5,000.00 0 $5,000.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Fee Amount
$100.50
$4.50
$22.11
$127.11
Fee Amount Invoice Amount Amount Paid Amount Owing
$127.11 5127.11 $0.00 $127.11
$127.11 $127.11
$0.00 $127.11
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and fmds 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: RMB Printed By: RMB
Print Date: 5/29/2002