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2004, 04-28 Permit App: 04002647 AdditionProject Number: 04002647 Inv: 1 Application Date: 4/28/2004 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: ADDTL 200 SF OF GARAGE Contact: DOUGLASS, HARLEY Address: 8510 N CRESTLINE C - S - Z: SPOKANE, WA 99217 Setbacks: Front Left: Right: Rear: Phone: (509) 487-9792 Group Name: Site Information: Project Name: Plat Key: Name: SUMMERFIELD EAST 04TH ADD District: H Parcel Number: 46354.9050 Block: 18 SiteAddress: 14903 E CROWN AVE SPOKANE, WA USA 99216 Location:: SPO Lot: 3 Owner: Name: DOUGLASS, HARLEY Address: 8510 N CRESTLINE SPOKANE, WA 99217 Zoning: UR -3.5 Urban Residential 3.5 Water District: 001 TRENTWOOD Hold: ❑ Area: ;,658.00 Acres Width: 103 Depth: 152 Right Of Way (ft): 45 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Permits: Building Permit Contractor: HARLEY C DOUGLASS INC Firm: HARLEY C DOUGLASS INC Address: 8510 N CRESTLINE #A Phone: (509) 487-9792 SPOKANE, WA 99217 This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation GARAGE U-1 VN 200 $2,400.00 200 $2,400.00 Totals: 200 $2,400.00 200 $2,400.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL PERMIT FEE 1 SELECT $75.50 STATE SURCHARGE 1 SELECT $4.50 RESIDENTIAL SURCHARGE 1 SELECT $16.61 REGIONAL PLNG SURCHARGE 1 SELECT $12.08 Permit Total Fees: $108.69 Operator: JAS Printed By: JAS Print Date: 4/28/2004 Project Number: 04002647 Inv: 1 Notes: Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 4/28/2004 Page 2 of 2 Payment Summary: Permit Type Building Permit Fee Amount $108.69 $108.69 Invoice Amount $108.69 $108.69 Amount Paid $ 0.00 $ 0.00 Amount Owing $108.69 $108.69 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: JAS Printed By: JAS Print Date: 4/28/2004