2001, 10-22 Permit App: 01009310 PorchArk
Sox SPokANF,CouNIT
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:
Assessors Tax Parcel Number(s):
Legal Description:
Project Description: .—/) C C 1< CIO
O''Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New /Change)
❑ Other
Department Use Only
Water District /Purveyor.
Sewer District /Purveyor
Road width
Setbacks
Front: Rear:
1 aft Right:
School District:
Fire District:
Zoning
OWNER /APPLICANT INFORMATION
❑ Owner:
^r
._ x�
Phone:
(-4:�-1 Fax:
❑ Applicant:
Phone:
Fax:
Mailing \ddresss:: (
.. 5 /O
/!/ • le r--pc- —4-t— ate(
Mailing Address:
2"d floor sq. ft.
City, St/
-
` /
City, State, Zip
Garage sq. ft.
❑ Contractor
Phone
Fax
❑ Architect /Engineer
Phone
Fax
Mailing address
Mailing address
City, State Zip 1C
C%
City, State Zip
WA State Contractor license #
Contact name:
TION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
/. /X z /cr.
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
1 leat source (electric, gas, etc.)
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
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / %) 0 Yes 0 No
Proposed use
\'alu,.
Relocation
Fire Safety
Firm Name
I'reyious address
Phone
lire Sprinkler
Tent
Paint booth _ Fire Alarm
Fireworks display
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / %) 0 Yes 0 No
Proposed use
\'alu,.
Special Inspections Required?
Non - Residential Energy Code Compliance?
Firm Name
What is the current use of this property?
Phone
Will the site be served by a septic system? 0 Yes 0 No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / %) 0 Yes 0 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 INFORMATI
Are there structures on the property? O Yes O No
Ifyes, 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 shoreline?
Ifyes, ident f on site plan 0 Yes 0 No
What is the current use of this property?
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes 0 No
Will the site be served by a septic system? 0 Yes 0 No
Is any part of the property within a 100 yr flood plain?
I /yes, identify on site plan
0 Maybe 0 Don't know 0 Yes 0 No
Are or will there be wells located on the property?
Ifyes, identify on the site plan 0 Yes 0 No
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifyes, identify on site plan 0 Yes 0 No
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / %) 0 Yes 0 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?
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
O No
Is public water available to the site? O 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?
Cl Yes 171 No
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ CASH ❑ CHECK ❑ am= ❑_- ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
EXPIRES:
SUBTOTAL
TOTAL FEE
MINIMUM PERMIT FEE IS $35.00 PLEASE
MAKE CHECKS PAYABLE 10 SPOKANE
TER
COUNTY PERMIT CENTER
Project Number: 01009310 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/22/2001 Page 1 of 2
Project Information:
Permit Use: 14 X 46 ENCLOSED PORCH (ALREADY
CONSTRUCTED) (AtstHekre D
Setbacks: Front EXI Left: 20 Right: 24 Rear: 123
Site Information:
Plat Key: 002601 Name: SWAN ACRES REPLAT #1
Contact: FURMAN, MARY
Address: 5518 N BANNEN RD
C - S - Z: SPOKANE, WA 99216
Phone: (509) 000-0000
Group Name:
Project Name:
District:
Parcel Number: 46353.1501 Block:
SiteAddress: 5518 N BANNEN RD
SPOKANE, WA 99216
Location:: SPO
Zoning: UR-3.5
Water District:
Area: 0 Sq Ft
Urban Residential 3.5
Width: 120
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Lot:
Owner: Name:
Address:
FURMAN, MARY
5518 N BANNEN RD
SPOKANE, WA 99216
Hold: 11
Depth: 217 Right Of Way (ft): 45
Review
Site Plan Re 'ew
Plan Review
Released :BY:
Septic System Review
Permits:
Released By:
Operator: RMB Printed By: RMB
Print Date: 10/22/2001
Project Number: 01009310 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/22/2001
Contractor: OWNER
Address: 0 Phone: (000) 000 -0000
000000, 00 000000
Building Permit
Page 2 of 2
Firm: OWNER
Const Category: New
Nbr Of Dwellings:
Bldg W x D: 14 x
Req Parking:
Building Characteristics
Group: R -3 Type: VN
1 Occupant Load:
46 Building Sq Ft:
0 Handicap Parking:
Description Grp Type Notes
STORAGE U -1 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:
Payment Summary
Permit Type
Building Permit
0 Building Height: 0 Stones: 1
644 Sprinklers: 0
0 Critical Materials: 0
This Application:
Sq Ft Valuation
644 $6,092.24
Totals: 644 $6,092.24
Units Unit Desc
1
1
1
Y OR BLANK
Y OR BLANK
Y OR BLANK
Permit Total Fees:
Fee Amount Invoice Amount
$157.61 $157.61
$157.61 $157.61
Total Project:
Sq Ft Valuation
644 $6,092.24
644 $6,092.24
Fee Amount
$125.50
$4.50
$27.61
Amount Paid
$0.00
$157.61
Amount Owing
$157.61
$0.00 $157.61
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: 10/22/2001
01009310
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/22/2001 Page 1 of 11
Project Information:
Permit Use: 14 X 46 ENCLOSED PORCH (ALREADY
CONSTRUCTED)
Setbacks: Front EXI Left: 20 Right: 24 Rear: 123
Site Information:
Plat Key: 002601 Name: SWAN ACRES REPLAT #1
Contact: FURMAN, MARY
Address: 5518 N BANNEN RD
C - S - Z: SPOKANE, WA 99216
Phone: (509) 000-0000
Group Name:
Project Name:
District:
H
Parcel Number: 46353.1501
Block:
SiteAddress: 5518 N BANNEN RD
SPOKANE, WA 99216
Location:: SPO
Zoning: UR-3.5
Water District
Area: 0 Sq Ft
Nbr of Bldgs: 0
Urban Residential 3.5
Lot:
Owner: Name: FURMAN, MARY
Address: 5518 N BANNEN RD
SPOKANE, WA 99216
Hold: [1
Width: 120 Depth: 217 Right Of Way (ft): 45
Nbr of Dwellings: 1
Review
Site Plan Re *ew
vKe Ii`lottrm
Plan Review
Septic System Review
Released By:
Operator: RMB
Printed By: RMB
Print Date: 10/22/2001