2005, 05-19 Permit App: 05001704 AdditionS4i�kSe
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BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: //3J7 E, o net
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: /a 4-4 /,o i,v_y di 011.7 —/r ra/!- ev
Building Permit ❑Change in Use ❑Grading 0 Manufactured Home
Relocation
.9ao/T/aL)
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
®
Owner A/ 9 /Zi? y ,LA- us/L
Phone: q z¢-gga z. Fax:
Address: / / 3 // E, /10"
SQ41769 (DILL, ✓ 1,04 qqZ
City State Zp Code
0 Applicant: 5.9).7,1
Phone: Fax:
Address:
City
State Zip Code
0 Contractor: /3o% _S-rr-rs,44, J 0 Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City
WA State Contractor License #: Contact:
Spokane Valley Bus. Liscense #: Contact:
State
Zip Code
City
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: / 2 /
DIMENSIONS: z 9,7c 4o /
# OF STORIES:
/
MAIN FLOOR TO SQ. FTG:
2"" FLOOR SQ. FTG:
UNPIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: �- 3
CONSTRUCTION TYPE:
et V.5
HEAT SOURCE: ,�
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:S
30J�.060
30% SLOPES ON PROPERTY:
(SEWERRR ON-SITE SEPTIC
SYSTEM?
MANUFACTURED HOME
Width:
Manufacturer:
Length:
Year:
Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler:
Tent:
Valuation: Above/Underground Storage Tank Size:
# of Heads: Fire Alarm: Paint Booth:
Fireworks Display: Blasting: Date/Time:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Inspector:
Address:
Phone:
Fax:
City
Phone:
State
Fax:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING
Firm Name:
❑ CONCRETE ❑ REINFORCEMENT
Phone:
Inspector(s):
Fax:
❑ WELDING
DISCLAIMER
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.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name
Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature: 7Zz--5, —rte
Project Number: 05001704 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Date: 5/19/2005 Page 1 of 3
Permit Use: 12 X 40 ADDITION - LIVING & KITCHEN TO
DUPLEX FOR 11311 E BOONE
Setbacks: Front NA Left: 13 Right: NA Rear: 100
Site Information:
Plat Key:
Contact: LAUER, HARRY A & LYNN M
Address: PO BOX 141221
C - S - Z: SPOKANE WA 99214
Phone: (509) 924-8502
Group Name:
Project Name:
Name: OPPORTUNITY TR # 01-354 District: Nort
Parcel Number: 45162.0546
Block: Lot:
SiteAddress: 11311 E BOONE AVE
Location:: CSV
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Owner: Name: LAUER, HARRY A & LYNN M
Address: PO BOX 141221
SPOKANE WA 99214
Hold: ❑
Area: 23,216 Sq Ft Width: 113 Depth: 205 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 2
Review Information•
Review
Site Plan Review
Plan Review
Released
Released By:
Permits _
Operator: DMD Printed 13y: DMD
Print Date: 5/19/2005
Project Number: 05001704 Inv: 1
•
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/19/2005
Contractor: STEENHARD INDUSTRIES
Address: 29609 N DUNN RD
CHATTORAY, WA 99003
Building Characteristics
Group: R-3
Total Area
Building Height
Stories
Type: VB
480
12
1
Building Permit
Page 2 of 3
Firm: STEENHARD INDUSTRIES
Phone: (509) 238-4606
Description Grp Type Notes
RES ADD R-3 VB
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Contractor: OWNER
Item Description
DUCT SYSTEMS
VENTILATING FANS
Contractor: OWNER
Item Description
TOILETSBIDETS
SINKS
SHOWERS
WATER PIPING - D W V
Operator: DMD
This Application:
Sq Ft Valuation
480 $35,846.40
Total Project:
Sq Ft Valuation
480 $35,846.40
Totals: 480 $35,846.40
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
480 $35,846.40
Fee Amount
$502.35
$4.50
$200.94
$707.79
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Plumbing Permit
Fee Amount
$10.00
$10.00
$20.00
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Fee Amount
$6.00
$6.00
$6.00
$6.00
$24.00
Printed By: DMD Print Date: 5/19/2005
Project Number: 05001704
Notes:
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/19/2005 Page 3 of 3
Payment Summary.
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$707.79
$20.00
$24.00
Invoice Amount
$707.79
$20.00
$24.00
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$707.79
$20.00
$24.00
$751.79 $751.79
$0.00 $751.79
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: DMD Printed By: DMD Print Date: 5/19/2005
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