2003, 03-11 Permit App: 03001528 Shop, PipingPROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 \\'13ST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: ) I L ti• 8. /.ta I. fb, 4A RCu n . �0/tigNt
Assessors Tax Parcel Number(s):
ysaal. 6701
Legal Description:
Project Description: S 1'4O P
4 Building Permit
O Change in Use
O Grading
O \Ianufacmrcd Home Permit
0 Relocation
O Sign
O Tenant (New/Change)
O Other
pepirtrnent Use Only
0 Applicant'
SNmE
Phone.
,\
\\'ate District/Puntor.
Sewer pednet/Puntyck.
Road width
.
'Setbacks.
Prong
laft•
_.
Rear.
Right
School 1) gtncr
-
Fire D trio
Zoning
_
•�
OWNER/APPLICANT INFORMATION
Lu/,otle who !lwu/d be g only ded reglydrng IGG pngnI
gowner Phnna. q vi 498 1
JR f SaP t4 k IFax
0 Applicant'
SNmE
Phone.
,\
\lain Dour ski_ It�
Mailing Address:
9\t2_q Si, 841.444 R BWO•
Mailing Address:
Total habitable space
0
2nd sy. ft. 0
"l floor
City, State, ZipCdr,
CPo !•c9 -t/ e / W9 9 9 2 O b
Stam, Zip
Construction hype sm(�
ro
Garage sq. it. c
0 Contractor Phone
Fax
0 Arc hitte r/l inginer
P ne
Fax
V
Marling address
Mailing address
City, State Zip
City, State Zip
\\'T Stare Contractor license *
Guntur name:
PRO IECT INFORMATION
• Building Information ..7‘,._
Iluilding height
tit peak
of slorics 1
\lain Dour ski_ It�
Unfinished basement sq. ft.
on
Dimensis I G
O ,<2 J La
Total habitable space
0
2nd sy. ft. 0
"l floor
Finished baseman sq. Ft.
Oeeupancc group Lt. k
Construction hype sm(�
ro
Garage sq. it. c
Deck sq. Ft.
Gist of project
Wan sturce (elcaric, gas. etc.)
Manufactured 'Home
Sign
AWhm is the square footage of the sign
face?
Ili w high is the sign?
Width:
Length: 1
Year
!,lake:
# of signs
Arca of existing signs
_
Phone
Proposed use
Value
Relocation .
Fire Safety ;
, Non -Residential Energy Code Compliance?
Previous address
fire Spnnkler
'fent
Paint booth Fire Alarm
Fireworks display
_
Phone
Proposed use
Value
Special Inspections Required?
.
, Non -Residential Energy Code Compliance?
Firm Name
Is your property ill a designated wildlife habitat area?
0 Don't know 0 Yes 0 No
Will the site be sen ed by a septic system? ❑ Yes 0 No
Phone
:Are or will there be wells located on the property?
/Eyes. idem?' on the site plat 0 Yes 0 No
Are there any wetlands, streams or ponds within 200 feet of the property?
If yes. identify on site plan 0 Ycs 0 No
Plans Examiner
Phone
1 nspectorc
Address
Inspector
Phone
0 Concrete
0 Welding
0
Bolting
0
Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are them structures on the property? 0 Ycs 0 No
If yes, identify on siteplm
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
If yes, identify an sitep/an 0 Ycs 0 No
What is the current use of this property?
Is your property ill a designated wildlife habitat area?
0 Don't know 0 Yes 0 No
Will the site be sen ed by a septic system? ❑ Yes 0 No
Is any pan of the property within a 100 yr flood plain?
]lyes, identify on site plan
0 Almbc 0 Don't know 0 Ycs 0 No
:Are or will there be wells located on the property?
/Eyes. idem?' on the site plat 0 Yes 0 No
Are there any wetlands, streams or ponds within 200 feet of the property?
If yes. identify on site plan 0 Ycs 0 No
Is there evidence of fill or excavation on the pmperry?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / %) 0 Yes 0 No
:Arc critical or hazardous materials used or stored 00 site?
0 Ycs 0 No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control:Area?
.;,., ❑''Ycs
0 No '.
Is public sewer available to the site? ' " ❑ Yes .,' ❑ No.
-' '
Is the property inside the ASA?
' -
. ❑ _Ycs
- ❑ Yes
0 No `
❑ No
Is public water available to the site?. 0 Ycs - 0 No
-•
Is the property inside the PSSA? -
0 Ycs
0 No
Is the property located within 1000 feet of a Natural ResourceArca?
0 Ycs 0 No
Dale Received:
Sniff Rearc.em;nisc:
METHOD OF PAYMENT
VI
❑ CIIIiCK ❑ ® ❑ 1 0
❑ cASII
QUUVER
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DAI'I f:
EXPIRES:
BANKC:ARD NU!IBFR:
AUI'I-TORI'/,I;:D SIGNATURE:
:
SUBTOTAI.
•. TOTAL FEE
MINIMUM PERMIT FEE ISFri. W PLLUE
"MAKE CI IECIS PAa"ARI.It'I0 SI'OI:ANE ..
COUNTS PISR Ill' CESIER
Project Number: 03001528 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/11/2003 Page 1 of 2
Project Information:
Permit Use: SHOP (36 X 36 W/12 X 24 LEAN-TO)
Setbacks: Front
Left: 12 Right: Rear: 15
Site Information:
Plat Key: 000382 Name: CHESTER HILLS ADD
Contact: SCHUH, JAY
Address: 2124 S BALFOUR BLV
C - S - Z: SPOKANE, WA 99206
Phone: (509) 924-4989
Group Name:
Project Name:
District:
F
Parcel Number: 45291.0709
Block:
SitcAddress: 2124 S BALFOUR BLV
SPOKANE, WA 99206
Location:: SPO
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Lot:
Owner: Nance: SCHUH, JAY
Address: 2124 S BALFOUR BLV
SPOKANE, WA 992116
Hold: ❑
Area: .00 Acres Width: 106 Depth: 250 Right Of Way (ft): 60
Nbr of Bldgs: 4 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Released ''
Plan Review
Permits:
Originally Released: 3/11/2003 By: jshatto
Released By
........................
Originally Released: 3/11/2003 By: ,jshatto
Operator: JAS Printed By: JAS
Print Date: 3/11/21103
Project Number: 03001528
Inv: 1
Application
THIS IS NOT A -PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/11/2003 Page 2 of 2
Contractor: OWNER
Const Category: New
Nbr Of Dwellings:
Bldg W s D: s
Req Parking:
Description
STORAGE
Building Permit
Firm: OWNER
Phone:
Building Characteristics
Group: Type:
Occupant Load: Building Height:
Building Sq Ft: Sprinklers: 0
Handicap Parking: Critical Materials:
Stories:
This Application: Total Project:
1:1m. Notes Sq Ft Valuation Sq Ft Valuation
U-1 VN 1.584 519.008.00 1,584 $19,008.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: OWNER
Payment Summary:
Permit Type
Building Permit
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 he construed to he 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.
Totals: 1,584 $19,008.00 1,584 $19,008.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Mechanical Permit
Firm: OWNER
Phone:
Fee Amount
$288.00
$450
$63.36
$355.86
ti 6
4'1 nitc4,
Fee Amount Invoice Amount
$355.86
$355.86
$355.86 $355.86
Amount Paid
$0.00
Amount Owing
$355.86
50.00
.8(> -316 .%1 C_
Signature:
Operator: JAS
Printed By: JAS Print Date: 3/11/2003
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