2009, 04-14 Permit App: 09000908 RemodelProject Number: 09000908 Inv:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Date: 4/14/2009 Page 1 of 2
Permit Use: BATHROOM REMODEL Contact: PACIFIC NORTHWEST CONSTRUCTIO
Address: 4121 N GLENN RD
C - S - Z: SPOKANE, WA 99206
Setbacks: Front Left: Right: Rear: Phone: (509) 342-1576
Group Name:
Site Information: Project Name:
Plat Key: 005709 Name: CHINOOK NO 3 ADD District: East
Parcel Number: 46364.0904 Block: Lot:
SiteAddress: 16412 E BROAD AVE
Location:: CSV
Zoning: UR -3.5 Urban Residential 3.5
Water District: 134 CONSOLIDATED ID #19 Hold: LI
Area: 11,062 Sq Ft Width: 86 Depth: 127 Right Of Way (ft): 50
Owner: Name: WISOWATY, PHILLIP & WANDA
Address: 16412 E BROAD AVE
SPOKANE VALLEY, WA 99216-353
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Building Plan Review
Released By:
Permits:
Originally Released: 4/14/2009 By: TMELBOU
Building Permit
Contractor: PACIFIC NORTHWEST Firm: PACIFIC NORTHWEST CONSTRU
Address: 4121 E GLENN RD Phone: (509) 342-1576
SPOKANE, WA 99206
This Application: Total Project:
Description Gr13 Type Notes Sq Ft Valuation Sq Ft Valuation
1&2 FAMILY R-3 VB BATHROO 0 $4,716.93 0 $4,716.93
M
REMODEL
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Totals: 0 $4,716.93 0 $4,716.93
Units Unit Desc Fee Amount
1 SELECT $111.25
1 SELECT $4.50
I SELECT $44.50
Permit Total Fees: $160.25
Operator: jmm Printed By: JD Print Date: 4/14/2009
41,
Project Number: 09000908 Inv:
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/14/2009 Page 2 of 2
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $160.25 $160.25 $44.50 $115.75
$160.25 $160.25 $44.50 $115.75
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: 4/14/2009
Spokane
Valley.
Community Development
Residential Construs
Permit Application
Permit Center
11703 E p.prage-AveT:Spitg(-3
SpokanetietklEyARNiALLEY
(509)0in iK6 'SOK: (509AV-0037
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ew Cons
Addition
Other:
PERMIT NUMBER: 04X-4)
PERMIT FEE:
ruction Accessory Bldg
Deck
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SITE ADDRESS:
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ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
Building Owner:
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Name:
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Phone: ..1.4.').‘S(7 b. Fax: ct...)..t... Ili sq
Address:
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IMPERVIOUS SURFACE
AREA:
City:
tate:
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Phone:
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CONSTRUCTION TYPE:
Contact Person
Name:
Phone:
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Describe the scope of work in detail:
Contractor:
Name: n
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Address: Lk i1 I r\l, Z:::.tpc-IT Pel ,
City: .....Statebo q Zip.
Phone: ..1.4.').‘S(7 b. Fax: ct...)..t... Ili sq
Contractor Lic•
NoTicAELZEtTt
City Business Lic, No:
Cost o Project: $ LIiq
Proposed Use:
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**************The followin MUST be com lete:
rite N/A if not a licable **********************
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
2' FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
..
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ, FTG:
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
CONSTRUCTION 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 applic
Method of Payment:
Cash
Bankcard #:
Authorized Signature:
REVISED 2115/07
y Check
DATE:
0 Mastercard 0 VISA
Expires: VIN#:
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CCY C\A-(1StC.