2002, 04-24 Permit App: 02002937 BreezewayProject Number: 02002937 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/24/02 Page 1 of 3
Project Information:
Permit Use: BREEZEWAY CONNECTING GARAGE
CONVERTED TO LIVING W/BATHROOM
Contact
Address
C -S-
Z
KIRBY, RALPH/SHEPARD, DONNA
8004 E CARLISLE AVE
SPOKANE, WA 99212-2201
Setbacks: Front 66 Left: NA Right: 14 Rear: 30+ Phone: (509) 891-2071
Group Name:
Site Information: Project Name:
r
Plat Key: 000000 Name: UNKNOWN
District: 1-1
Parcel Number: 45072.6905 Block: 211
SiteAddress: 8004 E CARLISLE AVE
SPOKANE, WA USA 99212
Location:: SPO
Zoning: UR -3.5
Water District:
Area: 9,460 Sq Ft
Urban Residential 3.5
Lot:
Owner: Name: KIRBY, RALPH/SHEPARD, DONN
Address: 8004 E CARLISLE AVE
SPOKANE, WA 99212-2201
Hold: ❑
width: 86 Depth: 110 Right Of Way (ft): 60
Nbr of 13Idgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Released By: Et Li ' & Z
Plan Review
Released I3y: _
1.44. cruudi O2 -
Special Inspections Released By: t 'k
y-t-t2Z_ _ fi ?[.cd v1 + ori CLF- 2 -Jo -
4 MST ice' c--0/•10
Septic System Review
Fct?ty sews: &icipred
S drpmc only.
Permits:
Operator: CKF
5
Released By:
Printed By: CKF
Print Date: 4/24/02
Project Number: 02002937 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/24/02 Page 2 of 3
Contractor: OWNER
Building Permit
Firm: OWNER
Phone:
Building Characteristics
Const Category: Addition Group: R-3 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height:
Bldg W x D: x Building Sq Ft: Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials: ❑
Description C:rp Tvpe
RESIDENCE R-3 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes
REMODEL
Contractor: OWNER
Item Description
VENTILATING FANS
MINIMUM FEE ADJUSTMENT
Contractor: OWNER
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
ELECTRIC HOT WATER TANK
WATER PIPING - DWV
Operator: CKF
Totals:
This Application:
Sq Ft Valuation
0 52,000.00
0 $2,000.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR I3LANK
Permit Total Fees:
Mechanical Permit
Stories:
Total Project:
Sq Ft Valuation
0 $2,000.00
0 $2,000.00
Fee Amount
$63.25
$4.50
$13.92
$81,67
First: OWNER
Phone:
Units Unit Desc
1 NUMBER OF
1 Select
Permit Total Fees:
Plumbing Permit
Firm: OWNER
Phone:
Units Unit Desc
1 NUMBER OF
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Printed By: CKF Print Date:
Fee Amount
$10.00
$25.00
$35.00
Fee Amount
$6.00
$18.00
56.00
56.00
$6.00
$42.00
4/24/02
Project Number: 02002937 lnv: /
Notes: .--
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/24/02 Page 3 of 3
WORK WAS COMPLETED BY PREVIOUS OWNERS PRIOR TO 1999 WITHOUT PERMITS.
Payment Summary: r
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained srithiu to he true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will he
complied with. Subsequent issuance of a permit shall not he contrued 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.
Fee Amount Invoice Amount
$81.67
$35.00
$42.00
$158.67
$81.67
$35.00
$42.00
Amount Paid
$0.00
$0.00
$0.00
$158.67 $0.00
Amount Owine
o $81.67
$35.00
$42.00
$18:67-
Signature:
Operator: CKF Printed By: CKF
Print Date: 4/24/02
.Q2
IDYI
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1\
PROJECT APPLICATION WORK SI-IEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 \X/EST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: ,3,-Q0 « r r Clare", �Lam`
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description:
r4 Building Permit
❑ Relocation
dc6 /Jc /Qc�Cal� oti 6 -co- ss-
O Change in Use
O Grading
O Manufactured Home Permit
O Sign
O Tenant (New/Change)
O Other
Department Use Only
Water Disuict/Pun eyor.
School District
Sewer District/Purveyor
Fire District:
.Zonings..::
OWNER/APPLICANT INFORMATION
`�/
p o.:
-4` f.0otr�.c-
Phone:
s gamed
Sit 2-07(i.Uihn
❑ Applicant
Phone:
Fax:
/,‘ii
\ddnw..
Fro p / 5
T'" floors y. G.
Mailing Address:
Occup. ncp gnn'p
cin, Stale, rap
o �.
coo
Q9a- .
z
City, Sum. "Lip
0 (bmna, r
542.—Lir
1'hnne
Fax rag
❑ ,Architect/En
Phone
Fax
Mailing :eddies.
Mailing address
¢r, Stam Zip
WA
Cih. sum Zip
State Cnntrac,nr hcen,c _
-
Contact naanc
/9t- o cJrZ( Building Information
Building height In peak
At of stories
Alain Floor sq. II.
UnlmisheJ basement sq. It.
Dime nsirms
'1'. sal habitable space
T'" floors y. G.
Finished basement sq. It.
Occup. ncp gnn'p
Construction pp..-
. Garage .y. G.
Deck sq. il.
Cost ofd pfnleCF
IIeat st lurCe (electric, gas. u1 c.)
Fee—c?r-re_
1
Manufactured Horne
Sign.. •'
Width: `
Length:
What is the square footage of the sign
face?
Flow high is she sign?
Year.
Make:
4 of signs
Area of existing signs
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(__-------%) 0 lyes No
Proposed use
Value
Relocation •
Fire Safety -
I,nn Name•
Precious address
Is your property in a designated wildlife habitat arca?
0 Don't know 0 Ycs % No
Fire Sprinkler _
Tent
Paint booth _ Fire Alam) _
Fireworks display
Is there evidence of fill or excavation on the property? -
0 Yes i* No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(__-------%) 0 lyes No
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
I,nn Name•
\C•har is (hes /cyrrent use of this property?
/Qr3t[...0
Is your property in a designated wildlife habitat arca?
0 Don't know 0 Ycs % No
Phone
Plans Examiner
Phone ..
Inspectors:
Is there evidence of fill or excavation on the property? -
0 Yes i* No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(__-------%) 0 lyes No
Are critical or hazardous materials used or stored on sir •?
0 Ycs Nkr No
Address
Inspector
Phone
❑ Concrete
0 Welding
0
Robing 0 Reinforcement
Address
Arc there stntcrures on the property? g Ycs 0 No-_— -- _
If1 s, IIIP/lll on site /a//
h' p
What is the current property sizc?
(square feet or acres) � $ !�' ,3 7
Is any parr of the property within 250 feet of a shoreline?
If yes, iden4fit on 44 plan .❑ Yes kgNo
\C•har is (hes /cyrrent use of this property?
/Qr3t[...0
Is your property in a designated wildlife habitat arca?
0 Don't know 0 Ycs % No
Will the site be served by a septic sestcm_Ar Ycs ❑ No '
Is any part of the property within a 100 yr flood plain?
Ilya, iden4fr on nee plan
0 ilavbc 0 Don't know 0 Yes Ar No
Are or will Ihcre be wells located on rhe property? -
Um, ideurh on the site p/n/I 0 Ycs git No '
Are there any wetlands, steams or ponds xvirhin 200 feet of the property?
lips, identify on the plan 0 Yes rLq No
Is there evidence of fill or excavation on the property? -
0 Yes i* No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(__-------%) 0 lyes No
Are critical or hazardous materials used or stored on sir •?
0 Ycs Nkr No
Is the property in a designated Stormwatcr Control Area?
❑Yes
0 N
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA? 0 Yes
0 Ycs
0
0
No
No
Is public waver available to the site? 0 Yes 0 No
Is the property inside the PSSA? 0 .Ycs
0
No
Is the property located within 1000 feet of a Natural Resource Arca?
❑Ycs ❑No
Dile Rome N'
. alt R. poo. orad, c:
METHOD OF PAYMENT
0 C.\NI
❑ CI IEEE ❑
INIUMME
VISA
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
' DAT
H:\NKC.UtD NU,NIRIfR:
•
EXPlItIts:
.\UTI R 11217.1?D SIGNATURE:
SURIYI'.\I.
TOTAL FEE
MINIMUM PERMIT FEE IS 5JSMPIJ ASE
MAKE (:I IliCIJ PAYABLE TO SPOLCtNli
COUNTY PER>Irr CIi?IER
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