2003, 03-11 Permit App: 03001527 SewerProject Number: 03001527 Inv: 1 A�PI1C1t1011 Date: 3/11/2003 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Prosect Information:
Parcel Number: 45193.0201 Block. 1 Lot: 1
SiteAddress: 810 S CENTER RD
SPOKANE, WA USA 00000
Location:: SPO
Zoning: RC Rural Conservation
Water District:
Area: .00 Acres Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Owner: Name: GOODSALL, JEFFREY & RICHEL
Address: 918 N HOMESTEAD DR
LIBERTY LAKE, WA 99019-8565
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review Information:
Review
Review by Utilities
Released �3y
Permits:
Sewer Connection Permit
Contractor: ALL SEASON CONSTRUCTION Firm: ALL SEASON CONSTRUCTION
Address: 34292 HWY 41 Phone: (208) 437-3837
OLD TOWN, ID 83822
Item Description Units Unit Desc Fee Amount
SEWER CONNECTION 1 NUMBER OF $85.00
PROCESSING FEE 1 Y OR BLANK $15.00
Permit Total Fees: $100.00
Operator: JEF Printed By:. JEF Print Date: 3/11/2003
Project Number: 03001527 Inv: I Applidation Date: 3/11/2003 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:. ... ... ......... ... ............. ..... .... ......
................................... ................... ....... ................. . .......... ........... I .................. ...............
CONTOL AREA FOR DRAINAGE MORITORIUM SEE MAPS FOR SPECIFICS
Payment Summary: ...... .. ........... .. ......... .. .... .
............................ . ....... ..................
... . .. .. .............................. ...... .............. ...
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Sewer Connection Permit $100.00 $100.00 $0.00. $100.00
$100.00 $100.00 $0.00 $100.00
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: JEF Printed By: JEF Print Date: 3/11/2003
NORTH
ARROW
39,
mg 553
ii
A
NOTE: MAKE TIES TO PERMANENT SURFACE FEATURES SHOWN ON PLANS
PROJECT NAME:
REF. DRAWING NO.
FILE NUMBER:
1, PARCEL. 1q3, o;? o i
IC in STREET:
"17
ADDRESS:
all
CONTRACTOR
INSPECTOR
COMPANY_. /4�
DATE INSTALLED
TEE
STUB: DIA. TYPE
LENGTH
44Y6,/
STATION_'�_,?,
LINE NO. S S 0
STA. OF AND DIREc,riON TO c
NEAREST MANHOLC_L_/2tL S Dr, 1227
INVERT EL. 2-6) 12,S�
DEPTH FROM NATURAL
GROUND TO STUB ' q.1� .
LOCAL 13.M. ELEV. c) 1-2
DESCRIPTION OF LOCAL B.M.
K -
PIPE GRADE—
FT. DCLOW TJ IESHOLD
HOUSE TYPE
REMARKS
Ul
0
(D
-4
01
O
_u
NORTH
ARROW
39,
mg 553
ii
A
NOTE: MAKE TIES TO PERMANENT SURFACE FEATURES SHOWN ON PLANS
PROJECT NAME:
REF. DRAWING NO.
FILE NUMBER:
1, PARCEL. 1q3, o;? o i
IC in STREET:
"17
ADDRESS:
all
CONTRACTOR
INSPECTOR
COMPANY_. /4�
DATE INSTALLED
TEE
STUB: DIA. TYPE
LENGTH
44Y6,/
STATION_'�_,?,
LINE NO. S S 0
STA. OF AND DIREc,riON TO c
NEAREST MANHOLC_L_/2tL S Dr, 1227
INVERT EL. 2-6) 12,S�
DEPTH FROM NATURAL
GROUND TO STUB ' q.1� .
LOCAL 13.M. ELEV. c) 1-2
DESCRIPTION OF LOCAL B.M.
K -
PIPE GRADE—
FT. DCLOW TJ IESHOLD
HOUSE TYPE
REMARKS
Ul
0
(D
-4
01
C CE9WED
City Of MAY 01 2003
SPOKANE VALLEY �
PERMIT # � U 0 L 0 0 N
BUILDING PERMIT APPLICATION
Box 1 OWNERoefr �'m sA << JOB LOCATION
OWNER'S ADDRESS��,v a CITY /� PHONE
jt
DESCRIBE JOB�� s
THIS PROPERTY IS OWNED BY: SINGLE/MA_RWE115__�
PARTNERSHIP CORP.
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BOX 2 CONTRACTOR'S NAME PHONE
CONTRACTOR'S ADDRESS CITY
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
- - - -
BOX 3 CONTACT PERSON OF PROJECT PHONE Za 66 r3s`y
ADDRESS T �ZSZ /��'7 �� CITY p�/��/�/— ZIP gel
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BOX 4 SEWER AVAILAB[ LITY to— WATER AVAILABILITY V& d-
--- -----------------
---------- - --- _________________________________
BOX 5 ESTIMATED PROJECT COST $ 7C2 EXISTING BLDG. VALUATION $ 9 0A�_
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BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing/ proposed) 1ST FLOOi0--0'00 2ND FLOOR /
3RD FLOOR / OTHER /
BASEMENT UNFINISHED
DECK
BASEMENT FINISHED
GARAGE
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT_
____________________________________________
- - - - --------____ -
BOX 8 (/) SINGLE FAMILY NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS ) ( ) EXISTING STRUCTURE
( )
COMMERCIAL/ INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT p m P_ IMPERVIOUS SURFACEZ D 0 0 SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough -ins) MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK. FLOW PREVENTERS, ET AL.
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BOX 10 Water Service meter size (if known) Also see BOX 4
BOX 11 Septic Tank - Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER / AGENT DATE - (OVER)