2007, 09-11 Permit App: 07003443 BreezewayPermit Center
S*Wane11703 E Sprague Ave, Suite B-3
pokane Spokane Valley, WA 9920 1'ti'
Valley (509)688-0036 FAX: (50 pFob *Mat
at
J www.spokanevalley.orti
Community Development 14U$. cOj1-
Residential:Construction miChikaaction
Permit Application
Other:_
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PERMIT NUMBER:3 Z3
PERMIT FEE:
Accessory Bldg
n Deck
SITE ADDRESS:
ASSESSORS PARCEL NO: LEGAL DESCRIPTION: /5/G/ L6 '
Building Owheri O * O p /
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Name:
Name:
Address: ��P4/i' Vzik -
Address:
CityLie262i-x ! State:id
Zip: "/It
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City: State: Zip:
Phone,�j+ 7� _Z�Fax:
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Phone: Fax:
30% SLOPES ON
PROPERTY: '
Contractor Lic No: Exp Date:
:COhtiet Persons ;_ �° `r'„ e,,;r'; � ?. _ ; ' ",':;c; `
HEAT SOURCE: �✓-/
City Business Lic. No:
Name: c -7... ...y; , ,Se/7er'
Phone: n _52-, 9. 6.7..--.2,55k..)
Describe the scope of work in detail:
Cost of Project: $ ;460.0 .00
Proposed Use:
i e-eze lit% J3 A to X b io
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**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:.D)Iyl_EN%OJ\I
X /D(
# OF STORIES: 6.,V/4_
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.: •
FTG:
2" FLOOR SQ. FTG:
rye/9
UNFIN BASEMENT SQ. FTG:
A7/�
IMPERVIOUS SURFACE
AREA: di✓/
FINISHED BASEMENT -
SQ. FTG: %lam4-
GARAGE SQ. FIG:
A/PN�'t
DECK/COV. P TIO SQ. FTG:
30% SLOPES ON
PROPERTY: '
# OF BEDROOMS: /1714C/���RU-
CTIjPN TYPE:
HEAT SOURCE: �✓-/
SEWER OR SEPTIC?
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling: the
dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The
signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done
in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of
Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or ordinances. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
SIGNATURE:
Method of Payment:
❑ Cash
Bankcard #:
0 Check
Authorized Signature:=
REVISED 2/15/07 �,..•-�` ,ac
❑ Mastercard
Expires:
DATE: 8/3/ /67
0 VISA
VIN#:
Project Number: 07003443 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 23 X 6 X 106 BREEZEWAY Contact: SELLERS, RONALD V
Address: 119 N BLAKE RD
C - S - Z: SPOKANE VALLEY, WA 99216
Setbacks: Front Left: Right: Rear: Phone: (509) 216-2552
Group Name:
Project Name:
Site Information:
Date: 9/11/2007 Page 1 of 2
Plat Key: 002755 Name: VERA
District: Nort
Parcel Number: 45154.2523 Block:
SiteAddress: 119 N BLAKE RD
Location:: CSV
Lot:
Owner: Name: SELLERS, RONALD V
Address: 119 N BLAKE RD
SPOKANE VALLEY, WA 99216
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA Hold: ❑
Area: 20,976 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Depth: 0 Right Of Way (ft): 40
Review Information:
Review
Building Plan Review
Released By:
Released subject to approval of Permit # 07001700
Originally Released: 8/31/2007 By: tmelbourn
Landuse/Zoning/HE Conditions
Permits:
Released By:
Originally Released: 9/11/2007 By: cjjanssen
Operator: jmm Printed By: JD
Print Date: 9/11/2007
Project Number: 07003443
Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 9/11/2007
Contractor: OWNER
Description Grp
RES ADD R-3
Building Permit
Finn: OWNER
Phone:
Page 2 of 2
(000) 000-0000
This Application: Total Project:
bps Notes Sq Ft Valuation Sq Ft Valuation
VB BREEZWA 0 $1,600.00 0 $1,600.00
Y
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Totals: 0 $1,600.00 0 $1,600.00
Units Unit Desc
1 SELECT
I SELECT
1 SELECT
Fee Amount
$69.25
$4.50
$27.70
Permit Total Fees: $101.45
Notes: ,
DO NOT ISSUE BREEZEWAY PERMIT UNTIL SHOP ADDITION PERMIT IS APPROVED AND
READY TO ISSUE - JD
DO NOT ISSUE BREEZWAY PERMIT UNTIL SHOP ADDITON PERMIT HAS BEEN
APPROVED AND READY TO ISSUE - JD
Payment Summary: „—
Permit Type
Building Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$101.45 $101.45 $0.00 $101.45
$101.45 $101.45
$0.00 $101.45
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 construed 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: jmm Printed By: JD Print Date: 9/11/2007
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RECEIVED BY
CITY OF SPOKANE VALLEY
SEP 0 5 2007
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