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2004, 10-16 Permit: BLD-04-07940 ResidenceSpokan� ��alley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Job Address: Description: Subdivision: Owner: Applicant: Address: Contractor: Address: THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit NEW SINGLE FAMILY RESIDENTIAL 1510 N CENTER ST SPOKANE VALLEY WA 99212 NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS WALKER, ELBERTA MILLER, CRNA. 6629 W RIVERVIEW DR COEUR D'ALENE, ID 83814 Application #: BLD -04-07940 Applied: Issued: Expires: Lot: Blk: Parcel No: 45182.0307 Phone: (208) 765-5170 Phone: Lic No: Zoning: 10/16/2004 04/14/2005 General Information: TYPE OF RESIDENTIAL PERMIT VALUATION BUILDING HEIGHT TO PEAK DIMENSIONS # OF STORIES # OF BEDROOMS FRONT SETBACK REAR SETBACK LEFT SETBACK RIGHT SETBACK OCCUPANCY GROUP CONSTRUCTION TYPE STRUCTURES ON PROPERTY CURRENT PROPERTY SIZE SERVED BY SEPTIC SYSTEM WELLS LOCATED ON PROPERTY TOILETS TUBS SHOWERS (PER TRAP) SINKS DISHWASHER 1 CLOTHES WASHER 1 WATER USING DEVICE 1 FUEL BURNING APPL <= 100,000 1 GAS LOG, INSERT, FIREPLACE 1 DRYER 1 FUEL BURNING WATER HEATER 1 GAS PIPING (ea. OUTLET) 3 VENTILATING FANS 3 TYPE II HOOD 1 sfr 100112 20 40 X 52 1 no 2 1 1 3 Fees: PLAN CHECK FEE TYPE II HOOD BASIC PERMIT FEE WSBCC SURCHARGE TOILETS TUBS SHOWERS SINKS DISHWASHER CLOTHES WASHER WATER USING DEVICE FUEL BURNING APPL <= 100,000 GAS LOG, INSERT, FIREPLACE DRYER FUEL BURNING WATER HEATER GAS PIPING VENTILATING FANS Total Calculated: Deposits/Receipts: Total Due: CITY OF SPOKIMIE VALLEY APPROVED FOR SUBMITTAL Initials /Date Building - Planning 4 (C 1 1648 n Public Works THIS IS NOT A RECEIPT C t,Stypie til 6 b FOR 399.74 10.00 999.35 4.50 12.00 6.00 6.00 18.00 6.00 6.00 6.00 15.00 10.00 10.00 10.00 3.00 30.00 1,551.59 0.00 1,551.59 T Royd- 4 D`iaasisE‘ Siaane .0,00FValley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 NEW SINGLE FAMILY RESIDENTIAL PERMIT Job Address. 1510 N CENTER ST SPOKANE VALLEY WA 99212 Description: NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS Subdivision: Owner: Applicant: Address• Contractor: Address: WALKER, ELBERTA MILLER, CORRENA 6629 W RIVERVIEW DR COEUR D'ALENE, ID 83814 Lot: Permit #: Elk: Parcel No: 45182.0307 Phone: (208) 765-5170 Phone: Lic No: Applied: Issued: Expires: BLD -04-07940 10/16/2004 11/01/2004 04/30/2005 Zoning: General Information: TYPE OF RESIDENTIAL PERMIT VALUATION CLOTHES WASHER WATER USING DEVICE FUEL BURNING APPL <= 100,000 GAS LOG, INSERT, FIREPLACE DRYER FUEL BURNING WATER HEATER GAS PIPING (ea. OUTLET) VENTILATING FANS TYPE II HOOD BUILDING HEIGHT TO PEAK DIMENSIONS # OF STORIES # OF BEDROOMS FRONT SETBACK REAR SETBACK LEFT SETBACK RIGHT SETBACK OCCUPANCY GROUP CONSTRUCTION TYPE STRUCTURES ON PROPERTY CURRENT PROPERTY SIZE SERVED BY SEPTIC SYSTEM WELLS LOCATED ON PROPERTY TOILETS TUBS SHOWERS (PER TRAP) SINKS DISHWASHER sfr 100112 1 1 1 1 1 1 3 3 1 20 40 X 52 1 3 ? r-3 5-n 1 no no 2 1 1 3 1 Fees: PLAN CHECK FEE TYPE II HOOD GAS LOG, INSERT, FIREPLACE DRYER FUEL BURNING WATER HEATER GAS PIPING VENTILATING FANS BASIC PERMIT FEE WSBCC SURCHARGE TOILETS TUBS SHOWERS SINKS DISHWASHER CLOTHES WASHER WATER USING DEVICE FUEL BURNING APPL <= 100,000 Total Calculated: Deposits/Receipts: Total Due: 399.74 10.00 10.00 10.00 10.00 3.00 30.00 999.35 4.50 12.00 6.00 6.00 18.00 6.00 6.00 6.00 15.00 1,551.59 1,551.59 0.00 THIS IS NOT A RECEIPT o Stiolane aosolFUalley NEW SINGLE FAMILY RESIDENTIAL PERMIT 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Permit #: BLD -04-07940 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 Staff Initials tre.,c X)/ /1/7/c! (1&% /(;//14. /%1e //- Signature Date THIS IS NOT A RECEIPT