2002, 12-04 Permit App: 02010811 AdditionProject Number. 02010811 Inv: 1
Application
Date 12/4/2002 Page 1 of 3
THIS IS NOT A PERMIT
Penalties Will be assessed for commencing work without a Permit
Project Information:
Permit Use: RES ADD -EXPAND KITCIIENS:LIVING
•
Setbacks Front 35 Left' 12 Right' Rear:
Site Information:
Plat Key: 111111647 Name: DORAS SUB
Contact: GLESSNER, DANIEL
Address: 2117 N DORA RD
C - S - Z: SPOKANE, WA 99212
Phone: (51)9) 362-2996
Group Name.
Project Name.
District: E
Parcel Number: 35124.0306
Block Lot:
SiteAddress. 2117 N DORA RD
SPOKANE, WA 99212
Location:: SPO
Zoning. UR -3.5
Water District
Area. II Si! Ft
Urban Residential 3.5
Owner. Name. GLESSNER, DANIEL
Address 2(17 N DORA RD
SPOKANE, WA 99212
Hold: ❑
Width: IOU Depth. 140 Right Of Way (ft): 50
Nbr of Bldgs. 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
4`-' Selitie ReviLri
Permits:
6
•Released BV: [,(G
74,2
i�- i�leij _ t) ( 7jPGrG/
Sy S )1�g ,- A - t K / iii 04j •
Operator MS Printed B. MS
Print Date: 12/4/2002
Project Number 02010811 Inv. 1
Application
Date. 12/4/2002 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Const Category: Addition
Nbr Of Dwellings: Occupant Load:
Bldg %V x D. s Building Sq Ft
Req Parking: Handicap Parking'
!Building Permit
Firm: OWNER
Phone:
Building Characteristics
Group: Type:
Building Height:
Sprinklers
Critical Materials
This Application:
S4 Ft Valuation
--tin— $114,312.00
692 $45.672.00
Description Grp Type Notes
2ND FLOOR R-3 VN
RES ADD R-3 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: OWNE
Iescri,ti.
DUCT MS
HEAT PU '^ .OR A/C 0-3 TONS
VENTILING :NS
MINIM FEE ADJ b _ TMENT
Contractor: OWNER
Item Descri'ti' n
TO ETS
SINKS
TUBS
ELECTRIC O ATER TANK
FLOOR D • INS
Operator: JAS
Stories
Total Project:
So Ft Valuation
1.732 $114,312.00
692 $45.672.00
Totals: 2.424 $159,984.00 2,424 $159,984.00
Units Unit Desc Fee Amount
I Y OR BLANK
I Y OR BLANK
I Y OR BLANK
Permit Total Fees:
Mechanical Permit
Firm. OWNER
Phone:
Units Unit Desc
—t— NUMBER OF
T— NUMBER OF
"—I—NUMBER OF
$1,195.00
$4.50
$262.90
$1.46240
Fcc Amount
$10.00
$12.00
$10.00
I Select $3 00
Permit Total Fees:
Plumbing Permit
Finn. OWNER
Phone
Units Unit Desc
I NUMBER OF
I NUMBER OF
I NUMBER OF
I NUMBER OF
2 NUMBER OF
Printed By: JAS
Permit Total Fees:
Print Date:
$35.00
Fee Amount
$6.00
$6.00
$6.00
$6.00
$12.00
$36.00
12/4/2002
Project Number: 02010811
Notes:
Inv 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/4/201)2 Page 3 of 3
Payment Sanutfarp:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fcc Amount
$1.462 40
$35 00
$36 00
Invoice Amount
$1,462 40
$35 00
$36.00
$1.533.40 $1,533.40
Amount Paid
$0 00
$000
$0 00
Amount Owing
$1,462.40
$35.00
$36.00
$0.00 $1.53340
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has hoth 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 he construed to be a permit for, or an approval of, any violation orany of the
provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator. JAS Printed By. JAS Print Date: 12/4/21102
10c1
111M1
SPoKARE COUN5TY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 \\ TEST BROAD\VAY AVENUE
SPOKANE, \VA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: a 1.7 N 50
rot go, 1N (fi s/ /
Assessor's Tax Parcel Number(s): ? 5 I z_ q e 03 b(,C)
Legal Description:
I. of La vi 8ioc.t 2, o5 0or4.5 SLbdl
Project Description: "€✓"fbr'
I9Tuilding Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
El Sign
El Tenant (New/Change)
❑ Other
V
DcpartrnentUse Only":.:...(''G:, `;"°".';.
Phone $o 9
i ra.
«\Vater Deana/ Pun e)in' _
Sewer Dt+mct/Pun'eytcr:
Mailing ,cadre..
Z 117 X.) 7n s4 K--51
., Road rtidth
/Setbacks+.'t:'�,
'front,-:..
Left'='� �': , :.
'oi
Ren
:. _ .
- . Right
Sch: to I District. -
Fire District ..
r ..
:Loping-
OWNER/APPLICANT INFORMATION
El Inrli,v/e n is hatch/e. unit,./ frcardbuIFeet
❑ crane,:
Da nn'p 1 (r-LcS 5 V
Phone $o 9
i ra.
3tool a9 le
❑ Applicant.f
0 e inn. ej
�I ",,tPhone 509 3ca 294(
61/44e -SC r ""V� Pay
Mailing ,cadre..
Z 117 X.) 7n s4 K--51
# of stones
Mailing Addte.o
2l ( 7 Al t) or
0
Cm, State, Zip
+5 (Ti
—le. ' Kt 2
Z
2—
Cr. State, Zip
512 bKC-4,C
t d4
5' S Z i Z
El co...,
5 c l T
Phone
ra,
Occupancy group
❑ Atchnectfltnlnneer
Garage sq ft .
Phone
Rao
Mailing eddies,
�q r +1 ..e„,
7s
t4bvsy-e_
I lent source C ---L
�' fJb
nc. G et}�)
hlvhng Ada.,
oty, State rap
Cttt. State Yip
\\ A State Contractor license =
Contact name.
PROTECT INFORMATION
, Building Information
.
,,,,,,ding height wreak
zZ
# of stones
I\ lain thine so. fl
Unfinished basement sq ft.
Dimensions
502 -7 X 1 1
"rural habitable apace
H/06
251 floor sq ft.
Finished basement sq ft.
(I J'
Occupancy group
Construction (type_.„,
Wont! t070 -L
Garage sq ft .
Deck sq. ft.
(;ost of pn gcct
0 U
I lent source C ---L
�' fJb
nc. G et}�)
Manufacriired Home .. •
Sign.
Width
Length-
What is the square footage of„he sign ,
face%
I low high is the sign?
Year,
Make'
# of signs
Area of existing signs
Is there evidence of fill or excavation on the property?
0 Yes 1—No
Proposed use
Value
Relocation'
Fire Safety
Finn Name
Previous address
Phone
Fire Sprinkler
Tent
Paint booth Fire Alarm
_
Firm orks display
_
Is there evidence of fill or excavation on the property?
0 Yes 1—No
Proposed use
Value
Special'Inspeetions Required?
Non=Residendal:Energy Code Compliance?
Finn Name
What is the current use of this propern'?
Phone
Is your property in a designated wildlife habitat area?'(
0 Don't know 0 Yes fir'*`V o
Plans Examiner
Phone
I nspt ri irs
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifper, identifr an site p/an 0 Yes 471-ilo
Is there evidence of fill or excavation on the property?
0 Yes 1—No
Arc there slopes greater than 30% on the propern'? (30 ft i�ts in 100 ft)
( / %) 0 Yes no
Address
Inspector
Phone
O C:onerete
O Welding
0 Bolting
0 Reinforcement
Address
ADDITIONAL SITE INFORMATION
Arc there structures on the property? u{ i'es 0 No
I f fel, identi on site plan
What is the current property sue? Sa ^,7 x
(square feet or acres)
Is any part of the property within 250 feet of a shoreltn
If yes, identify on site Jilin 0 Yes no
What is the current use of this propern'?
i 6p..ue
Is your property in a designated wildlife habitat area?'(
0 Don't know 0 Yes fir'*`V o
Will the site be served by a septic system? Yes 0 No
Is any part of the property within a 100 yr flood plain?
Ifjet, edentz' on site p(in/
0 Maybe 0 Don't know 0 Yes Ni)
Ate or will there be wells located on the property?
kw. ninthly on the rile plan 0 Yes "No
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifper, identifr an site p/an 0 Yes 471-ilo
Is there evidence of fill or excavation on the property?
0 Yes 1—No
Arc there slopes greater than 30% on the propern'? (30 ft i�ts in 100 ft)
( / %) 0 Yes no
Are critical or hazardous matenals used or stored on sine+
0 Yes :Ida No
DEPARTMENT USE ONLY
IS ilie, ptoperty' in a aesignitcdStormwatcr Control'Area?'42'- '
. ,. ., 0 Yds 'V..O'Nn
' Is public sewer available to the site?.
Is the property. inside the ASA? - O''i es. '.O No
.-.0 Yes.. 0'No
Is public water available to the s¢e?, ' ' 0 Yes -: Cl` No
Is the Property inside the I'SSA?. ' . 'O, Yes ;0 No -
-. .. . ... .. .' -
_ Is the property located within 1000 feet of a Natural Resource Area?
0 Yes . 0 No -
Date Reeused
Staff l(epreseniatne
METHOD OF PAYMENT
VISA
❑ cASII ❑ (:Ill'.cg ❑
❑ I'
0
OISCSVER
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DA'I'14
EN PIKES:
BANKCARI) NUNIRI':R:
A UTI101U ZEI) S1( ;NA' I'URI
SUBTOTAL
TOTAL FEE
. MINIMUM PERMIT FEE IS $35,00Pi.F SE
M.AKP. CHECKS PAI'A61.E'I O SPOKANE;
Ci lLN'IT Plili\fI I' CENTER - ,
°a
N
rp
r
iF - - ,;ng sd!-,.,,it o,! fnr ,,,.,-,croose of
7 : . . ,• .. ,• ::erect
' uc- a ('.:: i r..;sements
.
S .
Sir., ' .
'-ands,
• lreas
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