2003, 09-17 Permit App: BLD-03-02501 RemodelPERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: /' f 60 '3 -
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: `J v re el, (,p
!4 V e nu
6, 3 S
e .. 1 Is_
v4(/P/ cJA
Li a 43I a Y sG7'4 3
PERMIT DESCRIPTION: r e rKo d e r f u s i rt
DUILDING PERMIT
RELOCATION
vie (cs e
CHANGE IN USE ® GRADING
® SIGN D TENANT
1
C.14
(CS /Jo w&►. -i
C.14 K Add c v. o f e e- �) w r 4 E
ci44kcS -C grv.
MANUFACTURED HOME
D OTHER
OWNER / APPLICANT INFORMATION
Pt OWNER: Le) A r S 1�czS KiriS
PHONE: 56-5, 3f FAX:
® APPLICANT: �CIAC.`U f \t A1- ( it (�
PHONE:
FAX:
ADDRESS: /'(Cl' P E (34$1.)rte S®OP ADDRESS:
CITY,STATE, ZIP172r
$CONTRACTOR: JXdC ® ARCHITECT:
PHONE:
FAX:
ADDRESS:
CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE #
PHONE:
ADDRESS:
CITY, STATE, ZIP
FAX:
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: dD
BUILDING HEIGHT TO PEAK: aid. S
BUILDING DIMENSIONS: °15,5-/X f 3`
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE:
CURRENT SEPTIC USE:
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT:
2ND FLOOR SQ FT:
UNFIN BASEMENT:
FINISHED BASEMENT: -
GARAGE: PI ]( 111) -
COVERED
11COVERED DECK:
DECK:
MANUFACTURED HOME • SIGN
WIDTH:
YEAR:
LENGTH;
PIT SET:
MANUFACTURER:
SQ FT OF SIGN: HEIGHT OF SIGN:
# OF SIGNS: AREA OF EXIST SIGN:
TYPE OF SIGN:
RELOCATION FIRE SAFETY
PREVIOUS ADDRESS:
PROPOSED USE:
FIRE SPRINKLER: FIRE ALARM:
PAINT BOOTH: TENT:
FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER: PHONE: FAX:
ADDRESS:
CM, STATE, ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
° BOLTING °CONCRETE
FIRM NAME:
INSPECTOR(S):
REINFORCEMENT
PHONE:
WELDING
FAX:
BUILDING STAFF USE ONLY
IS PUBLIC SEWER AVAILABLE: 0 YES 13 NO IF YES: 0 COUNTY 0 CITY
IS PUBLIC WATER AVAILABLE: 0 YES 0NO IF YES, WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: CI YES 0 NO PSSA: 0 YES 0 NO
DATE:
METHOD OF PAYMENT:
CASH CHECK
BANKCARD #; EXPIRES: VIN #
AUTHOR/ZED SIGNATURE.
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
a
Z0.30tjd L9Sti17Z260S
SEP 16 2003 11:09 FR,
1814'
ZZ:Tti 2002 9T d3S
TO 3241567 P.03/03
3oonE
7c gnr/a SH3 GHS
** rnra mors ra-x W W
LS TVZE60S OZ:TT E00Z/6T/60
Spokane
4,000Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
RESIDENTIAL ADDITION/REMODEL
Job Address: 14008 E BOONE AVE
SPOKANE WA 99212
Description: RECONSTRUCT AN EXISTING ENCLOSED DECK INTO A GREAT ROOM
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
HASKINS LIVING TRUST
GARDNER, SANDY
14008 E BOONE AVE
SPOKANE, WA 99212
OWNER
Lot: Blk:
Application #: BLD -03-02501
Applied: 09/17/2003
Issued:
Expires: 03/15/2004
Parcel No: 45142.1635
Phone: (509) 924-9635
Phone:
Lic No:
Zoning:
General Information:
VALUATION
REROOF
BUILDING HEIGHT TO PEAK
DIMENSIONS
# OF STORIES
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
8000
N
20.5
13.5 X 45
1
no
no
Fees:
PLAN CHECK FEE
BASIC PERMIT FEE
WSBCC SURCHARGE
Total Calculated:
Deposits/Receipts:
Total Due:
61.30
153.25
4.50
219.05
0.00
219.05
THIS IS NOT A RECEIPT
09/19/2003 11:20 5090324567
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
SRHD EHS
{
TO 3241567
PAGE 01
P.02/03
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
RESIDENTIAL ADDITIbN/REMODEL
Job Address: 14008 E BOONE AVE
SPOKANE WA 99212
Description: RECONSTRUCT AN EXISTING ENCLOSED DECK INTO A GREAT ROOM
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
HASKINS LIVING TRUST
GARDNER, SANDY
14008 E BOONE AVE
SPOKANE, WA 99212
OWNER
Application 1M: BLD -03-02501
Applied: 09/17/2003
Issued:
Expires: 03115/2004
Lot: Blk: Parcel No: 46142.1635 Zoning:
Phone: (509)924-9635
Phone:
LM No:
General Information:
VALUATION
REROOF
BUILDING HEIGHT TO PEAK
DIMENSIONS
# OF STORIES
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
8000
N
20,6
13.6X45
1
no
no
Fees:
PLAN CHECK FEE
BASIC PERMIT FEE
WSBCC SURCHARGE
Total Calculated:
Deposit /Receipts:
Total Due:
61.30
16325
4.50
219.05
0.00
219.05
NOT A RECEIPT
SEP 16 2003 11:22
5093241567 PAGE.01