2002, 11-19 Permit App: 02010383 RemodelProject Number: 02010383 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/19/2002 Page 1 of 3
Project Information:
Permit Use: REMODEL KITCHEN Contact: BARRETT, PAT
Address: 10922 E 23RD AVE
C - S - Z: SPOKANE, WA 99206
Setbacks: Front Left: Right: Rear: Phone: (509) 924-5343
Group Name:
Site Information: Project Name:
Plat Key: 001393 Nanie: KOKOMO TOWNSITE District: F
Parcel Number: 45282.3615
Block: Lot:
SiteAddress: 10922 E 23RD AVE
SPOKANE, WA 99206
Location:: SPO
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Owner: Name: BARRETT, PAT
Address: 10922 E 23RD AVE
SPOKANE, WA 99206
Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 70
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Plan Review
Permits:
Operator: RM B Printed By: RMB
Print Date: 11/19/2002
Project Number: 02010383 Inv: 1
•
Applitation
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/19/2002 Page 2 of 3
Building Permit
Contractor: OWNER Firm: OWNER
Phone:
Building Characteristics
Const Category: Remodel Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: s Building Sq Ft: Sprinklers: 0
Req Parking: Handicap Parking: Critical Materials: ❑
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RESIDENCE R-3 VN REMODEL 0 $5,800.00 0 $5,800.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: OWNER
Totals: 0 $5,800.00 0 $5,800.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Fee Amount
$113.00
$4.50
$24.86
Permit Total Fees: $142.36
Mechanical Permit
Firm: OWNER
Phone:
Item Description Units Unit Desc Fee Amount
GAS PIPING 1 # OF UNITS $1.00
RANGE 1 NUMBER OF $10.00
HOOD -TYPE II 1 NUMBER OF $10.00
MINIMUM FEE ADJUSTMENT 1 Select $14.0(
Contractor: OWNER
Item Description
WAI`BR USING DEVICES
MINIMUM FEE ADJUSTMENT
Permit Total Fees:
Plumbing Permit
Firm: OWNER
Phone:
Units Unit Desc
1 NUMBER OF
1 Select
$35.00
Fee Amount
$6.00
$29.00
Permit Total Fees: $35.00
Operator: RMB Printed By: RMB Print Date: 11/19/2002
Project Number: 02010383 Inv: 1
Notes:
•
Application
Date: 11/19/2002 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$142.36
$35.00
$35.00
Invoice Amount
$142.36
$35.00
$35.00
$212.36 $212.36
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$142.36
$35.00
$35.00
$0.00 $212.36
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: RMB Printed By: RMB Print Date: 11/19/2002
411
SPOKE COUNTY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 \`/EST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: (6 a L, a 3 cc) . V Q
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: i� 1-rc 1}� I-) \RE M 00 F. L.
® Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
Department Use Only
Water District/Purveyor:
Sewer District/Pun-eyor
Road width
Setbacks
Front Rear.
Left: Right.
School District
Pire District:
Zoning
OWNER/APPLICANT INFORMATION
Indaa le irho dundd be , ontaded n tardnn Jl i r prnje,'/
gl (, ner,11 , (J J
Pa -C' C -K -C , RCNS' CC l l
Phone Q o2 (- S 3 ei 3
Fax S !`✓V1E
CI :\pphc�aant
/
3 t `M L.
Phone:
,a.
Ma,lmg Address
r 0 a_.)._ E. 2 3.c( A Ise,
llimcnsions
Nfading Address
2'd floor sq. ft.
Cih, State, Ztp
5 CY k 6 IQ 6., w P
1
z 06
Garage sq. ft.
Cay, State, 7.,p
Cost of pro ect
❑ Contractor Aub\
7 f"t I T ✓''✓ 1✓ k_so 1-)
Phone
lax
p p
9 p � — 0 O ) 1
El Architect ,'l.ntnneer
Phone
l'ax
I\lading address
Mailing address
(h-, State Zip
City, State Zip
\\ A State Contractor license 4
Contact name
PROTECT INFORMATION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
llimcnsions
Total habitable space
2'd floor sq. ft.
1 tntshcd basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of pro ect
I Icat source (electric, gas, etc.)
Manufactured Home''
'
Sign
Width:
Length:
Will the site be served by a septic system? 0 Yes ® No
Vi/hat is the square footage of the sign
face?
I low high is the sign?
Year:
Make:
Fireworks display
# of signs
Arca of existing signs
Proposed use
Value
Relocation
Fire Safety
Firm Name
What is the current use of this property? R E5 t D Er'ce
Previous address
Will the site be served by a septic system? 0 Yes ® No
Paint booth
Fire Sprinkler
'Tent
Fire Alarm
Fireworks display
Are critical or hazardous materials used or stored on site?
O Ycs I No
Address
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property? R E5 t D Er'ce
Phone
Will the site be served by a septic system? 0 Yes ® No
l'lans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
0 Ycs .® No
.\rc there slopes greater than 30°), on the property? (30 ft rise in 100 ft)
( / ° b) 0 Ycs Xi No
Are critical or hazardous materials used or stored on site?
O Ycs I No
Address
Inspector
Phone
O Concrete
0 Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
.\rc there structures on the property? O Yes 0 No
If yes, identifj, on site plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
If yes, identifi or site plan 0 Yes 0 No
What is the current use of this property? R E5 t D Er'ce
Is your property in a designated wildlife habitat arca?
0 Don't know 0 Ycs 0 No
Will the site be served by a septic system? 0 Yes ® No
Is any part of the property within a 100 yr flood plain?
Ifjes, identz, on site plan
0 Maybe 0 Don't know 0 Ycs 0 No
Are or will there be wells located on the property?
Ifjes, identify on the site plait 0 Yes ® No
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifjes, identiA on site plan 0 Ycs Crl, No
Is there evidence of fill or excavation on the property?
0 Ycs .® No
.\rc there slopes greater than 30°), on the property? (30 ft rise in 100 ft)
( / ° b) 0 Ycs Xi No
Are critical or hazardous materials used or stored on site?
O Ycs I No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
D Yes O No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA? 0 Yes 0 No
0 Ycs O No
Is public water available to the site? 0 Yes 0 No
Is the property inside the PSSA? 0 Yes 0 No
Is the property located within 1000 feet of a Natural Resource Area?
D Yes O No
Date Received:
Staff Representative
METHOD OF PAYMENT
VISA
0 (:.\SI1 ,1D GIII:C< 0 0 �■� 0
CIE
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
D.\11
EXPIRES:
BANKC.\RD NUMBI?R:
\UTI IORI'/ND SIGNATURI':
SUBTOTAL
TOTAL FEE
MINIMUM PERMIT FEE IS $35.00 PLEASE
MAKE CHECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER