2011, 09-07 Permit App: 11002739 RemodelProject Number: 11002739 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: FINISH LOWER LEVEL FAMILY RM & FRAME Contact: HORMANN, RONALD C & DEANNA M
IN FUTURE BATH Address: 1319 S SHAMROCK
C - S - Z: SPOKANE VALLEY, WA 99037-1640
Setbacks: Front Left: Right: Rear: Phone: (509) 924-4796
Group Name:
Site Information: Project Name:
Plat Key: 005024 Name: AUTUMN CREST 01ST ADD
Parcel Number: 45261.3003 Block: Lot:
SiteAddress: 15402 E 22ND AVE Owner: Name: HORMANN, RONALD C & DEANN
Address: 1319 S SHAMROCK
Location:: CSV SPOKANE VALLEY, WA 99037-164
Zoning: R-2 SF Res Suburban District
Water District: 010 VERA Hold: ❑
Area: 10,400 Sq Ft Width: 80 Depth: 130 Right Of Way (ft): 50
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Date: 9/7/2011 Page 1 of 2
District: East
Review Information:
Review
Building Plan Review
Permits:
Released By:
Originally Released: 9/7/2011 By: tmelbourn
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Qj j Tyne Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT F R-3 VB FINISH 0 $2,000.00 0 $2,000.00
FAMILY
ROOM
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Totals: 0 $2,000.00 0 $2,000.00
Units Unit Desc Fee Amount
1 SELECT $69.25
1 SELECT $4.50
1 SELECT $27.70
Permit Total Fees: $101.45
Operator: MBB Printed By: JD Print Date: 9/7/2011
Project Number: 11002739 Inv: 1
Notes: -
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 9/7/2011 Page 2 of 2
Payment Summary:
Permit Type
Building Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$101.45 $101.45
$27.70 $73.75
$101.45 $101.45 $27.70 $73.75
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: MBB Printed By: JD Print Date: 9/7/2011
Spokane
jValleya
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spokanevallev.org
(Staff Use Only)
PERMIT NUMBER: 1 Z7
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION ® ADDITION/REMODEL D ACCESSORY BUILDING
0 DECK 0 OTHER
SITE ADDRESS: / 5 . ra � r�C' u)'7 9 iao3 7
ASSESSORS PARCEL NO.: yS,g t j ,300g LEGAL DESCRIPTION: ,( .3 Jock / 19,))umer
BUILDING OWNER NAME: 'Roy, pr / cr o) r Iu -
711.r. C► � a.� /10 r xYM 6'n)"--
NAME:
ADDRESS: /3 i G S . S},tvmY- c.. k,
CITY:
PHONE: 5
CONTACT NAME: 5--
0 r p,r•
n,'Y1Y1
PHONE: coq_ 1/ -9 77
CONTRACTOR NAME:
STATE:
FAX: co__ 89r -76.x3
0 r 'Ay\ ren
CELL:
ZIP: ?q,037
5
9-79I-F)A6
FAX: s'D �._ (S1 7(,0`3 CELL:
r V -N^!•
S v9-`iqy-)o 7 v
Sio ? c t/ -' 0 7.
MAILING ADDRESS: /-. o - _ t,D2i o
CITY:
PHONE:
j�P T.a a role .•
c//7 /79/ -
CONTRACTOR LICENSE NO.: V f i F y -
STATE:
FAX: 24o 3 3 CELL:
ZIP:• fig° 3
5oq-et yy/el 3
EXPIRES: C)1) CITY BUSINESS LICENSE NO.: • . ylpv"
DESCRIBE THE SCOPE OF W9RK IN DETAIL 4ND INDCATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
11),)),
Dimensions:
r�.&
No. of Stories:
/i i4
Total Habitable
Space: /1\3,0
Main Floor SQ FT:
A),/1-•
Upper Floor SQ FT:
Unfinished Basement SQ
FT: ,t A-
Finished Basement SQ
FT: '0 1
Garage SQ FT:
9!J-
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:Property:
30% Slopes on
No. of Bedrooms:
Construction Type: i,C)co6-
Heat Source: `7 oS
Sewer or Septic: 3et.cll--
TOTAL COST OF PROJECT: $
'id C..O�c)
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit Is for construction 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) The City of
Spokane Valley permit is not a permit or approval fs any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be requi ed to be submitted and s • -•sequently approved before this application can be processed.
Signature
Date:
,7 o l l
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit-_Residential_11-11-11.doc