2005, 06-13 Permit App: 05002013 Pole BarnProject Number: 05002013 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 1728 SQ FT POLE BARN (24 X 48 W/24 X 24) Contact: DOUGLAS, DEBORAH A
Address: 16 N CLINTON RD
C - S - Z: SPOKANE VALLEY, WA 99216-0835
Setbacks: Front 50+ Left: 27 Right: 5 Rear: 7 Phone: (509) 939-9592
Group Name:
Project Name:
Site Information:
Plat Key: Name: TARTS SUB District: Nort
Date: 06/13/2005 Page 1 of 2
Parcel Number: 45154.2406 Block: 2
SiteAddress: 16 N CLINTON RD
Location:: CSV
Lot: 6
Owner: Name: DOUGLAS, DEBORAH A
Address: 16 N CLINTON RD
SPOKANE VALLEY, WA 99216-083
Zoning: UR -3.5 Urban Residential 3.5
Water District: Hold: ❑
Depth: 0 Right Of Way (ft): 0
Area: 17,280 Sq Ft Width: 0
Nbr of Bldgs: 2 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
Permits:
Released By: C .at,1q },
Operator: K_C Printed By: K_C Print Date: 06/13/2005
Project Number: 05002013
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 06/13/2005 Page 2 of 2
Contractor: OWNER
Group: U-1
Total Area
Building Height
Stories
Description
BARN
Type: VB
1728
20
1
Building Permit
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Grp Type Notes
U-1 VB
Item Description
RESIDENTIAL PERMIT FEE
ACCESSORY PLAN REVIEW
STATE SURCHARGE
Notes:
This Application: Total Project:
Sa Ft Valuation Su Ft Valuation
1,728 $32,832.00 1,728 $32,832.00
Totals: 1,728 $32,832.00 1,728 $32,832.00
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Fee Amount
$472.05
$118.01
$4.50
$594.56
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $594.56 $594.56 $0.00 $594.56
$594.56 $594.56 $0.00 $594.56
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: K_C Printed By: K_C
Print Date: 06/13/2005
Si�I&ne
_.�Vai1ey.000
tcot
'6'1'i 5(o BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: K1, 1(o C. -A', r\ N 'Z �. Voke... WIN . ?? (c)
Assessor's Tax Parcel Number(s): 4-6-159 . a y Olo
Legal Description: 11 e r v.. T�,.� �S ILL L - (c)13 _ 2 _
PERMIT DESCRIPTION: -DeA-v.\-c.v. «o �cy-5. (GrLye_
wilding Permit ❑ Change in Use ❑ Grading 0 Manufactured Home
❑ Relocation 0 Tenant Improvement ❑ Fire Safety ❑ Other
1
OWNER/APPLICANT INFORMATION
•Owner: -De,1DoruV. fs%-1)(-3,0.1,4,,A A 0 Applicant: SSM
Phone: Q�� - 3 s� Z Fax: Phone: Fax:
Address: I u, r,k ; ,‘Ao r, Address:
Spet<evne u"kkei X11\ `�'� ?.tis
City State Zip Code City State Zip Code
0 Contractor: Me. ❑ Architect: ,.Me
Phone: Fax: Phone: Fax:
Address: Address:
City State Zap Code City State
• WA State Contractor License #: Contact:
Spokane Valley Bus. Liscense #: Contact:
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK /
a
DIMENSIONS:
ayx4tw +Z,fXZy
# OF STORIES:
1
MAIN FLOOR TO SQ. FTG:
t aFs
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
13 p
GARAGE SQ. FTG:
17 Zg'
DECK/COV. PATIO SQ. FTG:
• I`-1 i\
OCCUPANCY GROUP:
-tor•
CONSTRUCTION TYPE:
-Poke -\ADc,
HEAT SOURCE:
iv N
# OF BEDROOMS:__
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
(11 I Z,, 00 0
30% SLOPES ON PROPERTY:
--4;"
SEWER OR ON-SITE SEPTIC
SYSTEM? SGS
Previous Address:
Proposed Use:
MANUFACTURED' HOME
Width:
Manufacturer:
Length: Year: Pit Set:
RELOCATION
1
FIRE SAFETY
Fire Sprinkler.
Tent:
# of Heads: Fire Alarm:
Paint Booth:
Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector. Phone: Fax:
Address:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
❑ REINFORCEMENT
Phone:
Inspector(s):
Fax:
El WELDING
DISCLAIMER
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.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name
nn Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
0 Cash Check 0 Mastercard ❑ VISA 0 Other
Bankcard #: Expires: VIN#:
Authorized Signature:
ADDRESS 6, 17 �� s
ZONE
ROAD W D
FRONT - FLANKING_. .
COMMENTS
REVIEWED BY
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