2009, 12-08 Permit App: 09003895 AdditionProject Number: 09003895 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/8/2009 Page 1 of 2
Project Information:
Permit Use: 360 SQFT ADDITION Contact: HANSON, SORAYA
Address: 19115 E BUCKEYE AVE #A
C - S - Z: SPOKANE VALLEY, WA 99022
Setbacks: Front Left: Right: Rear: Phone: (509) 927-4417
Group Name:
Project Name:
Site Information:
Plat Key: 004018 Name: SP -0327-84
District: East
Parcel Number: 55082.0133 Block:
SiteAddress: 19115 E BUCKEYE AVE
Location:: CSV
Lot:
Owner: Name: HANSON, SORAYA
Address: 19115 E BUCKEYE AVE #A
SPOKANE VALLEY, WA 99022
Zoning: R-4 SF Res Urban District
Water District: 134 CONSOLIDATED ID #19 Hold: ❑
Area: 5.00 Acres Width: 231 Depth: 702 Right Of Way (ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Building Plan Review
Released By:
Septic Sys Review
Originally Released: 12/7/2009 By: tmelbourn
Released By:
Originally Released: 12/7/2009 By: LHALSEY
Landuse/Zoning/HE Conditions
Permits:
Released By:
Originally Released: 12/7/2009 By: mharnois
Operator: JD Printed By: JD Print Date: 12/8/2009
Project Number: 09003895 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/8/2009 Page 2 of 2
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RES ADD R-3 VB 360 $34,858.80 360 $34,858.80
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Notes:
Septic designed for 4 bedrooms.
Totals: 360 $34,858.80 360 $34,858.80
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Fee Amount
$492.25
$4.50
$196.90
Permit Total Fees: $693.65
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $693.65 $693.65 $196.90 $496.75
$693.65 $693.65 $196.90 $496.75
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: JD Printed By: JD Print Date: 12/8/2009
CITYOF
Stiokane
Valley
Community Development
Residential Construction
Permit Application
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
PERMIT NUMBER:
PERMIT FEE:
New Construction
Addition/Remodel
Other:
Accessory Bldg
Deck
SITE ADDRESS: H&cE. & . t//k:-l--
ASSESSORS PARCEL NO: 55 eVc2. DI 33 LEGAL DESCRIPTION:
Building Owner:
DIMENSIONS: -
# OF STORIES: i . .---------,
.
Name: / fel dal_
I )
/7 a n ..s - 0 if\._
Address: / f //5 '— ,
c:
-e-
citYpokAne
t, State: id 4
Zip: enDd.,
Phone. 7 _ /0/ 5._
Fax:
Phone:
Contact Person
Name: %Sorc1ct. VI S
Phone:2/7 —
Describe the swf
e4ez-Z2c"-,
Proposed Use: ile4 "fc'26-4-11;z-a
Contractor:
DIMENSIONS: -
# OF STORIES: i . .---------,
.
Name:
MAIN FLOOR TO SQL fz_.
FTG: do A
2Nu FLOOR SQ. FTG:
Address:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
City:
State:
Zip:
Phone:
Fax:
HEAT SOURCE:
ele C -M C.—
Contractor Lic No:
Exp Date:
City Business Lic. No:
Co,st of Project: $ 3 s'ex' °
,1 /?2aJ -11.e e
&4 -mi
**************The following MUST be complete: (write NIA ifnot annhicahIe**********************
HEIGHT TO PEAK:
a :
DIMENSIONS: -
# OF STORIES: i . .---------,
.
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQL fz_.
FTG: do A
2Nu FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:
A1/47
DECK/COV, PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
...
CONSTRUCTION TYPE:
/'1 A'c.
HEAT SOURCE:
ele C -M C.—
SEWER OR SEPTIC?
se_ih a
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 Pa
El Cash
Bankcard #:
menta
Authorized Signature:
REVISED 2/15/07
0 Check 0 Mastercard
Expires:
DATE:
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CSV PERMITGEN i• LIP
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VISA
VIN#:
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