2002, 06-19 Permit App: 02004975 Deck�;vlv
SPOW, COUN'T'Y
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF I3UILDING & CODE ENFORCEMENT
1026 \VEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: 55--z_ , gales &f
\ssessor's Tax Parcel Number(s): lvS33 1 02-21
Legal Description
Nikon( ,4 i/ Z� z/� L% z
Project Description:
0.472 an, rernadel eAlsAi ix/ 2-
I3uilding Permit'
❑ Change in Use
❑ Grading
El \Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
Depatliuent Use Only" ,.
Water Ditrict/Puncyor.--
Sewer laistriet/Purveyor
Road width
,Setbacks
1runi Rear.
1aitE night
Schutt] Distort -
I District
'a.-
Zoning ,
OWNER/APPLICANT INFORMATION
El lndiate mbn should he mnladed rr emini Ibr pn*cI
❑ v Phone: 9z6 -/713
(/Y/4n jJ'74arn Fa.:
❑ Appticnm:
mune:
Fa,:
A admg.l S BA //
�5L //( /��/�
Mailing Address:
# of stones
City,5 ,Zip
alts 1444- %'9 za6
Cit-, Srare, Zip
,{.J/
IJ ?nttrn ¢ ` "hone5(79— 99a— 93< T
(keati/2'? 4Citi £ / a/AGV Fax 5n9 -2j2-0291
❑ Archlrca/Hng'neer
Phone
Fax
Mailing address
1/'// /1/ G�jomla lel
Mailing address
6,,,,,e- I
ilV� /04-99&D g
clnv, Slam Zip
Const rociun hypo
WA . law Corm:min
Deck sq. B.
l /fal
�f
PRO IECT INFORMATION
Building Information
Building height to peak
# of stones
Main floor sq. fl.
Unfinished basement sq. it.
Dimen tions
0x/ZU/0Y/Z-
Total habitable space
2nd floor sq. ft.
Finished basement sq. ft.
( kruipancy
eaipancy group
Const rociun hypo
( sq. it
Deck sq. B.
l /fal
�f
Cost et project
60
Il eat source (electric, gas, c¢.)
Manufactured Home
Sign , i
width:
Length:
What is the square footage of the sign
fact?
I low 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)
( /E]4') 0 Yes C"No
Proposed use
Value
Relocation ,
Fire Safety ..
....<.
_..-..
Previous address
Is your property in a designated wildlife habitat area?Will
O Don't know O Yes No
Fire Sprinkler
fent
Paint booth Fire Alarm
Fireworks display.
_
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /E]4') 0 Yes C"No
Proposed use
Value
Address
Special Inspections Required?
Non Residential Energy Codc Compliance.,
Firm Name
\W hat is the cure use f this ropers?
Is your property in a designated wildlife habitat area?Will
O Don't know O Yes No
Phone
Is any part of the property within a 100 yr flood plain?
Ifyes, ident f • on site plan
0 Maybe O Don't know O Yes No
Plans I aminer
Phone
Inspectors:
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /E]4') 0 Yes C"No
Are critical or hazardous materials used or stored on site?
�
0 Yes IWNo
Address
Inspector
Phone
O Concrete
0
Welding
0 li ,Iting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there stmemres on the property? ' Yes O No
If yes, identify an site plan
What is the current property size? / ,7 /
(square feet or acres) (Z 517 5-6 it
Is any part of the property within 250 feet of a shore) te?
No
If yet, identify on site plan O Yeses B
\W hat is the cure use f this ropers?
Is your property in a designated wildlife habitat area?Will
O Don't know O Yes No
the site be served by a septic system? O Yes Lrl'No
Is any part of the property within a 100 yr flood plain?
Ifyes, ident f • on site plan
0 Maybe O Don't know O Yes No
Are or will there be wells located on the property?
Iyer, identtfr on the rite plan 0 Yes LWtN'o
Are there any wetlands, streams or ponds within 200 feet of the property?
If yes, 'dentin, on ideplan 0 Yes 12/No
Is there evidence of till or excavation 00 the property?
0 Ycs i
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /E]4') 0 Yes C"No
Are critical or hazardous materials used or stored on site?
�
0 Yes IWNo
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? - . -
OYcs 0No
Is public sewei available to the site? 0 Yes 0 No
. Is the property inside the ASA? - 0 Yes 0. No ,.
0 Yes .0 `No
Is pubhe water available to the site? - '0 Yes- 0 No t
Is the property inside the PSSA? 0 yes 0 No
Is the prol,eity Ideated within 1000 feet of a Natural Resource. Arca? -, - -
0 Yes •0 No. ' . _•_ ..
Date Preeis--ed:
stair R,pre.,nr,ti,,:
METHOD OF PAYMENT
visa
9 CASI I 9 CIINCK 9 0
0
DUC•VER
m: s=
FAXED PERMITS WILL ONLY BE ACEPTED WITFI PAYMENT OF A MAJOR CREDIT CARD
EXPIRES
IIANKt ARI) NUMBER:
AL} IIi01iIZEI) SIGN ATURI'::
SUED /TA].
TOTAL FEE
MINIMUM PERMIT FRE IS $35.00PI.Iu6C
MA KIS C 11 ECK,S PAYABLE TO SPCIA.\NI?
COUNTS 115101 Ir CF_Nma
- '
Project Number: 01004975 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/19/2002 Page 1 of 2
Project Information:
Permit Use: EXTEND EXISTING DECK (10 X 12) AND
RENOVATE EXISTING DECK
Setbacks: Front EXI Left: 21» Right: 17 Rear: 60
Site Information:
........................................................
Plat Key: 001629 Name: MIDILOME
Contact: CREATIVE DECKS AND DOCKS
Address: 31411 N CHIPMUNK RD
C - S - Z: CHATTAROY, WA 99003
Phone: (509) 990-9384
Group Name:
Project Name:
District: F
Parcel Number: 45331.0221 Block: 2
SiteAddress: 3522 S BATES RD
SPOKANE, WA USA 001100
Location:: SPO
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Area: 12,525 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: :.._._
Lot: 21
Owner: Name: KINGHORN, CAROLYN
Address: 3522 S BATES RD
SPOKANE, WA 99206-5944
Hold: ❑
Depth: 0 Right Of Way (ft): 50
Review
Site Plan Review
(i/ C c t 72 1C(4-iC1e e sed ;3
6
Plan Review
Permits:
Operator: RMB Printed By: RMB
Print Date: 6/19/2002
Project Number: 02004975 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/19/2002 Page 2 of 2
Contractor: CREATIVE DECKS & DOCKS
Address: 31411 N CHIPMUNK RD
CHATTAROY, WA 99003
Building Characteristics
Const Category: New Group: R-3
Nbr Of Dwellings: 1 Occupant Load: 0
Bldg W x D: x Building Sq Ft:
Req Parking: Handicap Parking:
Building Permit
Firm: CREATIVE DECKS & DOCKS
Phone
Description Crp Tvpe
DECK R-3 VN
DECK R-3 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:
Payment Summary:
Permit Type
Building Permit
(509) 990-9384
Type: VN
Building Height:
Sprinklers: ❑
Critical Materials: ❑
This Application:
Notes Sq Ft Valuation
120 $939.60
RENOVATI 0 $5,060.40
ON
Stories:
Total Project:
Sq Ft Valuation
120 $939.60
0 $5.060.40
Totals: 120 $6,000.00 120 $6,000.00
Units Unit Desc Fee Amount
1 Y OR BLANK $113.00
1 Y OR BLANK $4.50
1 Y OR BLANK 524.86
Permit Total Fees:
Fee Amount Invoice Amount
$142.36
$142.36
$142.36 $142.36
Amount Paid
50.00
$142.36
Amount Owing
5142.36
50.00 $142.36
Disclaimer:
Submittal of this application certifies the owner (or person(%) authorized by the owner) has both examined and finds the information
contained within to he true and correct, and agrees that all provisions of laws and/or regulations governing this hype of work will be
complied with. Subsequent issuance of a permit shall not he contrued to he a permit for, or an approval of, any violation of any of the
provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: RMB Printed By: RMB Print Date: 6/19/2002
s
ra
WINDOWS
19720 BOTHELL - EVERETT HVVY, S.E., BOTHELL, WA 98012-8124
PHONE: (425) 481-7101 OR FAX 1 -(800) -$ALPINE
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