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2002, 02-11 Permit App: 02000797 AdditionSPOMI\TCOUNIY PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 \VEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: R--, n Assessor's Tax Parcel Number(s): Legal Description: Project Description: Building Permit O Change in Use O Grading O 'Manufactured Home Permit 0 Relocation O Sign O Tenant (New/Change) O Other •.,.. Departnient Use ()ply- •:, •:....,:.f..ii„v.6-. . ,. .• , r.).L.„., - . 0 Applicant: gernac, \N:ater 1)istrict/I,,urveyor. '.....- ' . . : .„,- Se‘ier pistpci/NiveY9`1,,'.-7 ", Road Width . . :i.Sillip-eks Left; :: ' - Righr Sch.)] DistUct . ' Occupancy group o Contracti;r Phone Fax • , OWNER/APPLICANT INFORMATION Ei Im&u/e mho sbould be ,oniaded arribm thin rit()"'"er: Plione:DOI OrAL \ , Cvelai :Krrne.4 Ci ))-r.../V \-1 0 Applicant: gernac, Phone: Fax: c Fax: Gz°1PIQ 6-46-1 Mailing Address: Datil s 1-34-,)°,,,r Mailing Address: Total habitable space cay,smic, Zip 5 -lin \r{f' c-Pia,oSio Cil, State, Zip Occupancy group o Contracti;r Phone Fax 0 Architect/Engincef Phone Fax klailing address Mailing address CM, State Zip. City, State Zip WA State Contractor license ,-; Contact name: PRO ECT INFORMATION I ; .•.• '.,: Blinding Tilformatuin • • . - .e -- Builtling height to peals # of stories Nlain noor sq. 1-1. lbinnisbeil basement sq 6. Dimensions 1C--) Xa0 Total habitable space 2rl5 floor sq. ti Finished basement sq. ft. Occupancy group Construction type Garage sq. ft. Uccle sq. ft. Cost of project I hill 'Pima' (electric, gas. etc) etp-CD Manufactured Home Signe. " ;- \Width: Length: What is the square footage of the sign face? nom" high is the sign? Year: Make: # of signs Arca of existing signs Phone Proposed use Value Relocation .. - -,. Fire Safety . Previous address•.. fire Sprinkler "Pent Paint booth Fire Alarm Fireworks display _ Phone Proposed use Value Special Inspections Required? What is the current property size? (square feet or acres) ) AK— -t(Is Non-ResidentialEnergy, Code Compliance? `. Finn Name Is your property in a designated wildlife habitat arca? ❑ Don't know ❑ Yes No Will rhe site be served by a septic system? 0 Yes No Pham Are or will there be wells located on the proper Ilya, ide,mfr on Ibe tirep/em 0 ves No there any wetlands, streams or ponds within 200 feet of the property? If yet, identh' on site plan 0 Yes 'O No Plans I,>amincr Phone I nspenon: Address Inspector Thane ❑ Concrete O Welding ❑ Bolting ❑ Reinforcement Address ADDITIONAL SITE INFORMATION Arc there structures on the property? 'Ll., Yes ❑ No If yet, identify an .rite plat What is the current property size? (square feet or acres) ) AK— -t(Is isany part of the property within 250 feet of a seshoreline? If yes, /den* 0t site plan 0 Yes.No What is the currc tt use of this propert? Is your property in a designated wildlife habitat arca? ❑ Don't know ❑ Yes No Will rhe site be served by a septic system? 0 Yes No Is any part of the property within a 100 yr flood plain? !lye!. identib, on site pltm 0 \laybc 0 Don't know 0 Yes NEkNoAre Are or will there be wells located on the proper Ilya, ide,mfr on Ibe tirep/em 0 ves No there any wetlands, streams or ponds within 200 feet of the property? If yet, identh' on site plan 0 Yes 'O No Is there evidence of fill or (Ala reanon 011 the property? 0 Yes .'-'1, No Are them slopes greater than 301/4 on the property? (30 ft fisc in 100 ft) ( /n/o) 0 Yes 'No --_ Are critical or hazardous materials used or stored on :irk c? 0 YesIMW.11 No DEPARTMENT USE ONLY • Is Ole property in a designated Stormwater Control Area?` / 0 Yes 'XNo Is public sewer available to the site? A Yes 0 No • - - jjj �� •- Is the property inside the ASA? 'les 0 No - Yes 0 No Is public water available to the site? es O No Is the property inside the PSSA? Yes 0 No Is the pro c located within 1000 feet of a Natural Resource Arca? ❑ Yes No Date Received: • — 1-6Q-- Marr RE] use, '? c a METHOD OF PAYMENT ❑ CAS]] VISA ❑ ( II (ix ❑MOM 0 DIJCOVER ra1010^NA? • FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: ExI'I Itlis: 1:ANKCARD NUMBER: AU'fl 1( Mt Z1 .:1) SIGN:\ tl RE: SUBTOTAL TOTAL FEE MINIMUM PERMIT FEE 15 S3SW PI E'SIi .\I.\KI'. CI II C.KS PAYABLE TO SPOKANE ' COC -NT\ "1'-R V IT (ILNTER Project Number: 02000797 Inv: 1 ` Application THIS PS•NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 2/11/02 Page 1 of 2 Project Information: Permit Use: RES ADD - GREAT ROOM Setbacks: Front Site Information: Left: 60 Right: Rear: 250 Plat Key: 000382 Name: CHESTER HILLS ADD. Contact: GILBERT, JAMES Address: 2207 S BALFOUR BLV C - S - Z: SPOKANE, WA 99206 Phone: (509) 924-6099 Group Name: Project Name: District: F Parcel Number: 45291.0612 Block: SiteAddress: 2207 S BALFOUR BLV SPOKANE, WA 99206 Location:: SPO Zoning: UR 3.5 Water District: Area: Lot: Owner: Name: GILBERT, JAMES Address: 2207 S BALFOUR BLV SPOKANE, WA 99206 Hold: ❑ 0 Sq Ft Width: 105 Depth: 320 Right Of Way (ft): 60 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Review Information: c— --- - --- - Review Site Plan Review Plan Review Permits • [Released By: Originally Released: 2/11/02 By: jshatto IReleased By: Originally Released: 2/11/02 By: jshatto Operator: JAS Printed By: JAS Print Date: 2/11/02 j Project Number: 02000797 Inv: / Application• Date: 2/11/02 THIS IS NOT A .PERMIT Penalties will be assessed for commencing work without a permit Contractor: OWNER Address: 0 000000, 00 000000 Building Permit Page 2 of 2 Firm: OWNER Phone: (000) 000-0000 Building Characteristics Const Category: Addition Group: R-3 Type: VN Nbr Of Dwellings: Occupant Load: Building Height: Stories: I Bldg W x D: 20 x 20 Building Sq Ft: 400 Sprinklers: ❑ Req Parking: Handicap Parking: Critical Materials: ❑ This Application: Total Project: Description Grp Type Notes So FI Valuation Sq Ft Valuation RES ADD R-3 VN 400 $24,800.00 400 $24,800.00 Item Description RESIDENTIAL VALUATION STATE SURCHARGE. RESIDENTIAL SURCHARGE Totals: 400 $24,800.00 400 $24,800.00 Units Unit Desc 1 Y OR BLANK 1 Y OR BLANK 1 Y OR BLANK Fee Amount $350.50 $4.50 $77.11 Permit Total Fees: $432.11 Mechanical Permit Contractor: OWNER Firm: OWNER Address: 0 Phone: (000) 000-0000 000000, 00 000000 Item Description DUCT SYSTEMS MINIMUM FEE ADJUSTMENT Notes: Payment Summary: Permit Type Building Permit Mechanical Permit Units Unit Desc Fee Amount 1 NUMBER OF $10.00 1 Select $25.00 Permit Total Fees: S35.00 Fee Amount Invoice Amount Amount Paid Amount Owing $432.11 $35.00 $432.11 $35.00 $0.00 $432.11 $0.00 $35.00 $467.11 $467.11 $0.00 $467.11 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be contrued to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: JAS Printed By: JAS Print Date: 2/11/02 ,..„.., l J 4') �.il l� 1 1 1 I_ '- A f;tel S, T9 A o �$ a m ` 9 `L��Oy L�, s oam a qt. P� ad* cc .. X T �Q s•;