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2004, 06-30 Permit App: BLD-04-04795 Residence• sill a► I Planning REVIEWED FOR CODE COMPLIANC SPOKANE VALLEY BUILDING DIVISION I Public WorkS-1 THIS IS NOT A RECEIPT THIS IS NOT A PERMIT CITYO Penalties will be assessed for AL commencing work without a permit V91e3' NEW SINGLE FAMILY RESIDENTIAL 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Application #: BLD -04-04795 Job Address: 1409 S DAVIS LN Applied: 06/30/2004 SPOKANE VALLEY WA 99216 Issued: Description: NEW RESIDENCE W/ATTACHED GARAGE - GAS Expires: 01/09/2005 Subdivision: Lot: Blk: Parcel No: 45224.4401 Zoning:, Owner: CURRY, GORDON W & DOROTHY L Applicant: CURRY, GORDON W & DOROTHY L Phone: Address: 9209 E TRENT AVE SPOKANE, WA 99206-4295 Contractor: EXCELL CONSTRUCTION CO Phone: (509) 928-0600 Address: 14313 E TRENT AVE Lic No: excelcc2891g SPOKANE WA 99216 - General Information: Fees: TYPE OF RESIDENTIAL PERMIT sfr PLAN CHECK FEE 4.35.58 VALUATION 116483 TYPE II HOOD 10.00 CLOTHES WASHER 1 DRYER 10.00 GARBAGE DISPOSAL 1 FUEL BURNING WATER HEATER 10.00 FLOOR DRAINS 1 GAS PIPING 2.00 WATER PIPING/DRAIN-IN WASTE 0 VENTILATING FANS 30.00 WATER USING DEVICE 2 BASIC PERMIT FEE 1,088.95 FUEL BURNING APPL <= 100,000 1 WSBCC SURCHARGE 4.50 DRYER 1 TOILETS 12.00 FUEL BURNING WATER HEATER 1 TUBS 6.00 GAS PIPING (ea. OUTLET) 2 SHOWERS 12.00 SINKS 18.00 VENTILATING FANS 3 DISHWASHER 6.00 T TYPE II HOOD 1 CLOTHES WASHER 6.00 BUILDING HEIGHT TO PEAK 15 GARBAGE DISPOSAL 6.00 DIMENSIONS 40 x 33 FLOOR DRAINS 6.00 # OF STORIES 1 WATER USING DEVICE 12.00 # OF BEDROOMS 3 FUEL BURNING APPL <= 100,000 15.00 OCCUPANCY GROUP r-3 CONSTRUCTION TYPE 5-b Total Calculated: 1,690.03 STRUCTURES ON PROPERTY 1 Deposits/Receipts: 0.00 SERVED BY SEPTIC SYSTEM no D 1,690.03 WELLS LOCATED ON PROPERTY noTot CITY OF SPOKALLEY,, TOILETS 2 APPROVED FOR SUBMITTAL Tuss SHOWERS (PER TRAP) 2 Initials/ Date. SINKS DISHWASHER 3 1 � Building • sill a► I Planning REVIEWED FOR CODE COMPLIANC SPOKANE VALLEY BUILDING DIVISION I Public WorkS-1 THIS IS NOT A RECEIPT Street Address: Assessor's Tax Pai Legal Description: BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone; (509)68-0036; Fax: (509) 688-0037 � v REQUIRED SITE INFORNWON PERMIT DESCRIPTION: Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home ❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION ❑ Owner: (!dor) (irk Phone: 9Woo Fax: Address: /-/3/ rew C tate Zip Code ❑ Contractor: Phone: >. Fax: Address: 1, , 313 zS_ C S to Zip Code WA State Contractor icense #: bko 0j PERMIT BUILE ❑ Applicant: Phone: Fax: Address: City State Zip Code ❑ Architect: Phone:. Fax: Address: City State Zip Code `1 Mhtact: ING INFORMATION HEIGHT TO PEAK DIMENSIONS: x33# OF STORIES: / MAIN FLOOR TO SQ. FTG: 2 FLOOR SQ. FTG UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ: FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: CONST TION TYPE: HEAT SOUR: . # OF BEDROOMS:TOTAL HABITABLE SPACE: IPPERVIOUS SURFACE AREA: COST OF ROJECT: �� 30% SLOPES ON PROPERTY: SEVIIER�R ON-SITE SEPTIC Width: Length: Manufacturer: Previous Address: Proposed Use: _ Fire Sprinkler: Tent: Valuation: MANUFACTURED HOME Year: RELOCATION FIRE SAFETY # of Heads: Fire Alarm: Fireworks Display: Blasting: Above/Underground Storage Tank Size: Pit Set: Paint Booth: Date/Time: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address: Inspector: Address: ❑ BOLTING Firm Name. I nspector(s): Phone: Fax: city State Phone: Fax: city SPECIAL INSPECTIONS ❑ CONCRETE ❑ REINFORCEMENT Phone: Fax: Zip Zip ❑ WELDING 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) Tlis 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 c Print Name - !� V Signature l Method of Payment; (Faxed permit applications will only be accepted with major bankcard) ❑ Cash - ❑ Check ❑ MastercardVISA Bankcard #: Authorized Signature: Expires: VIN#: ❑ Other Project Addr ss: Owner: Mailing Address: Contractor: Mailing Address: / MECHANICAL PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036, Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Parmit I Icp• Zip Code AUTHORIZED SIGNATURE: # OF TOTAL DESCRIPTION OF WORK UNITS X 'COST = AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $15.00 = 2 FUEL BURNING APPLIANCE More than 100,000 X $19.00 = 3 UNLISTED APPLIANCE Additional Fee Equal to or less than 400,000 X $50.00 = 4 UNLISTED APPLIANCE Additional Fee More than 400,000 X $100.00 = USED APPLIANCE (WSEC min. AFUE X _ $50.00 5 rating)E ual to or less than 400,000. USED APPLIANCE (WSEC min. AFUE 6 rating) More than 400,000 X _ $100.00 7 BOILER/REFRIGERATION 1 -100M BTU X $15.00 = 8 BOILER/REFRIGERATION 101 - 500M BTU X $28.00 = 9 BOILER/REFRIGERATION 501 -1,000M BTU X $39.00 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU X $57.00 = 1180ILER/REFRIGERATION More than 1,750M BTU X $95.00 = 12d GAS LOG GAS INSERT, GAS FIREPLACE X $10.00 = X $10.00 = 13 RANGE 14 DRYER X $10.00 = 15 FUEL BURNING WATER HEATER X 1 $10.00 = 16 MISC. FUEL BURNING APPLIANCE X $10.00 = 17 GAS PIPING each outlet X $1.00 = Is DUCT SYS -IEMS X $10.00 = 19 VENTILATING FANS X $10.00 = 20 AIR HANDLER DOES NOT include ducting) Equal to or less than 10,000 CFM X $12.00 = 21 AIR HANDLER DOES NOT include ducting) Greater than 10,000 CFM X $19.00 = 22 EVAPORATIVE COOLERS X $10.00 = 23 TYPE t HOOD X $50.00 = 24 TYPE II HOOD X $10.00 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12.00 = 26 AIR CONDr"ONER 3-15 TON X $20.00 = 27 AIR CONDITIONER 15-30 TON X $25.00 = 28 AIR CONDITIONER 30-50 TON X $35.00 = 29 AIR CONDITIONER More than 50 TON X $60.00 = 30 LPG STORAGE TANK X $10.00 = 31 WOOD OR PELLET STOVE/INSERT X $10.00 = 32 WOOD STOVE - FREE STANDING X $25.00 = METHOD OF PAYMENT: SUBTOTAL ❑ CASH ❑ CHECK IQtVISA ❑ MC DATE: PROCESSING FEE $35.00 EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: PLUMBING PERMIT APPLICATION "�e City of Spokane Valley Community Development Department llPP1111�Da j BuildingDivision galley 11707 E. Sprague Avenue, Suite 106' Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Project Addr ss: / q0'7 Permit.Use: Owner: Mailing Address: Contractor: Mailing Address: / V3/3 Phone (Daytime Contact): 01 -o 11 city, QJ State Zip Code License #: Phone #: city BANKCARD NUMBER: AUTHORIZED SIGNATURE: # OFTOTAL DESCRIPTION OF WORK UNITS X COST AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6.00 - 2 URINALS X $6.00 = 3 TUBS X $6.00 - 4 SHOWERS PER TRAP BATH, STALL, ON-SITE BUILT X $6.00 - 5 SINKS LAVSIBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, X $6.00 = JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT 6 DISHWASHER X $6.00 - 7 CLOTHES WASHER X $6.00 - 8 GARBAGE DISPOSAL l X $6.00 - 9 WATER SOFTENER X $6.00 - 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, / X $6.00 = CONDENSATE 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 - 13 FOUNTAINS DRINKING X $0.00 = 14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION, ALTERATION, X $6.00 = VENT, PLUMBING, REVERSAL REPAIR, REVERSALS 15 SEWAGE EJECTOR GRINDER SUMP PUMP X $6.00 - 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, X $6.00 = CARBONATOR, SWAMP COOLER 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P_B.P.D• FOR: X $6.00 = VATS, TANKS BOILERS 18 INTERCEPTORS GREASE TRAP, SAND TRAP, X $6.00 = CHEMICAL HOLDING TANK 19 MEDICAL GAS r outlet NITROUS, OXYGEN X $6.00 - 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: SUBTOTAL PROCESSING FEE $35.00 ❑ CASH ❑ CHECK aVISA ❑ MASTERCARD I TOTAL PERMIT FEE DUE: DATE: EXPIRES: I BANKCARD NUMBER: AUTHORIZED SIGNATURE: Dhaenew,-) Square I , - 171 +S' N89.56'22' E ._. 44__44 .. ... .. .. ...._.,led z 50.00' 50.00• p, 969.70- g.8C. f TRACT "A' 59.07` . ........ � er H �6RE'.A N mcommunity Park 54� "sm a e 7.94 Dhaenew,-) Square 1 sl46'4Q I 87,84• a 006 m� 3 a 1.516 Sr Y r7 O 2 JO. rn 1 E.4&58 71 S. 50.00, N89.56'22' E 50.00' 50.00• 50.00' 50.00• _ 969.70- g.8C. 7 gg 59 21' ........ 59.07` . ........ � 73.97 1 .. .. ... ............ 61.73. Tat 57.67' 3500' 55.00' 54� "sm a 55.00'35.00• � ..6 sr �' 72g 144,x• L' .A23 v y 12 2 5g5�$ 4444 4444... .. ... 4444. 4444. Y 4444... 4444. .......... 4444.. 4444.. .................. ... 8^ n n a n n t..31.44• T2 $ $ 50.00• 50.00' 1 50.00' I 1 4 0= rj $ $ yp o $ 4 7$ $ 'yyyq" e 8$ 4 g$ e (((" TRACT 'Er d r cow��, � g Sa 2 6'650 Y 0.716 a v 3.6,. Y .� ..615 sr rel ..MS a ..� ..so st ,.fit ..OS a m 1 9,016 a 6056 'oo • Y , ! �� R.V.Paddug Sr ` .� I �+55.00' Cl, 44.37• I 55.00' 53.00' 55.00' 55.00' mA ✓ ; `+5500 �AVALON LANE_ 61e956'2rE 553.29' '.(PRP/ATE ROAD) _ 363.79 TRACT "C 1 sl46'4Q I 87,84• a 006 m� 3 a 1.516 Sr Y r7 O 2 JO. rn 1 E.4&58 71 S. 50.00, 50.00• 50.00' 50.00• 50.00' 50.00• _ 5 g.8C. 7 gg 8 �$ -.10 0$ 11 Tat o 'L'•$42 a `fj' L 4.523 m 54� "sm a f.Us v� � ..6 sr �' 72g i 4.523 v Y L' .A23 v y 12 2 5g5�$ 3 4 1gloi v 5 IF �! Y 4 q li 5.106 x yn 8^ n n n n t..31.44• T2 50.00• SOHO• 50.00• 50.00' 1 50.00' 1 50.00• 40.00' 4 uti v iJ �. �a J.• 4 L6 SF I `8y u 4 N84582tE 366.79' $ . .4 -�frl h•tA as 4346 v s G� � I \ L.45.33' 27.30' 5S.50• 53.50' 53.50' 53.50' 53.50' $3.50' _ 8 5.001 s 5.901 v 19'SB'2tw 56756'22"w Tat 100.09• 99.74 t 55.0068 8 x - +.nee a 2 5g5�$ 3 4 1gloi v 5 IF �! 6 4p+$ i•-' ..6+2 v R 7 'o.► 3.6.2 sr ? ->i 8^ 05.: ssr s.Al v at s 37'..... 4444 3.61. ' 1 Te a m to 27.30' w 53.50' 53.50•53.50' 53.50' 53.50' 53.50' N87561tE MAMER WJE 366.79• a 1 8 (PRNATE ROAD) TRACT "C - 50.00• So.ow 50.001 50.o0' 1 40.00• t ! , I 1' „ } � � ` , Y . ,' /26.59• 8 ,¢ 58756'22" -w/nam, Z O gS 1 2 3 4 +,414 v P X417 v TRACT ./ W o 6414 v : 84.414 v COMMON Art w'f4 3.266 sr 5 5.20! u g 1 1 1 i vflr v / A'.... ............. ... 1"- ---'---1 - l ........... 1 � w ,r- I B! I 157.7 r� 1 1 1 - - _ - - -t , 'fin;; i .. �.• Yc 50.00 50.00 622 ae• ... 4444.. _ 30.00' SO.Od I I f t 1 + ;1 I mCo>mmunity Paiic I I; l I If \ T f I t I -T 15TH WJE jI II I I I I I I r I I L_---1----1_�---1-._J-l,---L_----L--1--- �--� ! \ .....69.76 77 , RAC oti! 4444.. uNo� 10 2. $: 6.eeA V 1 EXt$i1NGI Eq l HO 16' FUTURE Ai � I is ls• a 1 r 410.}7• 1 V 16' FUrUwc AC - OF wtt6111( FOR EVERGRE •r2 ro 19'58'22-w - 0 79.54' ? T7 o� o g 8 5.001 s 5.901 v 19'SB'2tw 56756'22"w 100.09• 99.74 TRAC 55.0068 8 x - +.nee a r 34.03 Se756'22'w N 99..63' a 8^ 05.: ssr s.Al v is ls• a 1 r 410.}7• 1 V 16' FUrUwc AC - OF wtt6111( FOR EVERGRE •r2 ro 19'58'22-w ,o t m m Z 4 o� o g 5.001 s 19'SB'2tw 0 100.09• rJ TRAC 55.0068 8 �:J+rv01 r 34.03 i758.2tw 100.22• s.Al v 1 s 37'..... 4444 3.61. ' 1 ?viw• 1 ' I l I � 1 SEE SHEET 3 FOR ALL ' EASEMENTS & ADDRESSES l ------------------------------- I ' 1 u 4 d :ONCRET z 50'-0" 470 0 0 0 C m a 2 1 t.) LAWN for 1 /469 Sr , a a d LAWN El 41. .5 _DA a F?n!',S• J d, .44/. �cr e� �aav lu��c riY 11 I ' ZONE ROFROAAD Mff, FLAri�etan.� SCALE' 1" =20' (��.;W g/ REW 15' SIDEWALK & ' � t3 UTILITY EASEMENT I u Y'. 011 ud SPOKANE COUNTY STANDARD 9-9 CURB INLET TYPE "r STA. 22+21.67, 13,5' RT. I T,C,=2074.18 W z z Ca ' f s• d ........... SPOKANE COUNTY STANDARD 8--11,6-13 CONCRETE INLET TYPE. "1" WITH TYPE "2" METAL FRAME TYPE "2" METAL GRATE STA 22+14.97, 28.03' RT. GRATE ELEV. = 2073.45 SPOKANE COUNTY STAND B-1 S TYPE "B" DRYWELL WtiH TYPIC `3" METAL FRAME TYPE "4" SOLID COVER STA. 22+10, 18' RT„ UD ELEV'.. 2074.24 12 L.F. OF 1 t C.P.E. S=.4100 I E%-2071.23 IE s)=2071.35 1V. . Vis. I �--a, l I �. I L i ,l 22 I p ND "fit I ti 7. t r � , 5 1 40 00' 0 10 LML TY EASEMENT DAMS LANE his site Plan is. bei obtaining n9 o*pet"M tt d tw Mb (`p cepresentationuiof the+ i hs ar+0 aines/dimehsions, curb 1�p Allmom pmmft Have been ib bodies Of Akew4clilid as TTOM ELEV.= 2072.95 £S 9 RMNiLEV.=2074.3$ ../7, jo ciir INLAND h0���,� .� , shoe 5 ENOWERINO bHAENENS SQUARE PHASE 11 707 rwez 7th SWU 200 _,. (5W) '�-SUO Spclmwsb SMA 001M *' FAX: t;3Qe) ase -6844 ... DATE- 02/13%97 . _ INLAND PACIFIC ENGINEERING 707 West 7th • Suite 200 (509) 458—_8840 Spokane; Wil 99204 FAX: (509) 458-6844 LOT .1, BLOCK 5 DHAENENS SQUARE PHASE II DATE. 02/13/97 SCALE: 1"=20' 15' SIDEWALK & UTILITY EASEMENT \60.00' SPOKANE COUNTY STANDARD c �� B-9 CURB INLET TYPE "2" u STA. 22+21.67, 13.5' RT. T.C.=2074.18 W22; I— `.. z `. I z' Q A , 5 `. SPOKANE COUNTY STANDARD -.5,...... �g ` �I LI B-11,6-13 CONCRETE INLET TYPE. "1" WITH TYPE "2" METAL FRAME "2" TYPE METAL GRATE I o STA 22+14.97, 28.03' RT. GRATE ELEV. = 2073.45 SPOKANE COUNTY STAND 22' B-15 TYPE B' DRYWELL WITH TYPE "S' FRAME "4" I POND TYPE SOL DL COVER STA. 22+10, 18' RT„ LID ELEV. = 2074.24 .. 12 L. F. OF 12" C.P.E. ' S=.0100 IE{N)=2071.23 IE S =2071.35 ' 40.00' t� �w `� ASN �A OQ `t? 10 UTILITY EASEMENT DAVIS LANE -o FSS/ St . ONAL POND BOTTOM ELEV.=2072.95 EXPIRES 2Z2 BERM ELEV.=2074.38. _ INLAND PACIFIC ENGINEERING 707 West 7th • Suite 200 (509) 458—_8840 Spokane; Wil 99204 FAX: (509) 458-6844 LOT .1, BLOCK 5 DHAENENS SQUARE PHASE II DATE. 02/13/97 1515 S. Mamer Lane Spokane Valley, WA 99216 To: Mr. Gordon W. Curry From: DSHA Board of Directors Subject: Proposed site location for new home Date: August 29, 2004 Dear Mr. Curry: After meeting with you, reviewing your building plans and subsequent discussions with the City of Spokane Valley Building officials, it appears your current plan is not in compliance with. applicable codes for, proper setbacks. Also, the stake showing the necessary height for the foundation/slab has not been placed as you agreed to do, so we are unable to answer your question as to the pitch for the roof. Unfortunately, based on this information, we cannot support the proposed home as currently designed. We are as eager as you are to complete this project and will do our best to work with you and find an acceptable plan. Cc: City of Spokane Valley Tom .Scholtens, Building. Official' .Sandra Raskell, .Assistant Engineer 77T�j,:� cs��11 f September 7, 2004 Terry Reed •Dhaenens Square Homeowners Association 1515 S Mamer Ln Spokane Valley, WA 99216 RE: Building permits located at 1409 S Davis Ln Dear Mr. Reed, This letter is in response to an unsigned registered letter the City of Spokane Valley received from your association. I have made a copy of that letter and enclosed it. I would have contacted you personally had the letter listed a phone number or contact name. The City of Spokane Valley issued building permits to Excell Construction Co. on 08/18/2004, after a complete review for the construction of a 1458 sq ft single family dwelling. The legal description of this parcel is Lot 1 Block 5 Dhaenens Square 2"d Addition, parcel #45224.4401 with an address of 1409 S. Davis Ln. It was brought to our attention by your association that there were some concerns as to the house being built within a swale, which did not appear on our recorded final plat. After some investigation by the City of Spokane Valley we did conclude that there was a swale on that lot. The City of Spokane Valley contacted Excell Construction Co. to provide us with a revised engineered site plan proposal showing the locations of the swale and the proposed dwelling. Excell Construction Co. complied with our request immediately, and has been granted approval to continue with their project. Should you have any questions or concerns regarding this matter, please contact me between the hours of 8:00 a.m. to 5:00 p.m. at 509.688.0035 Sincerely, Dawn Dompier Permit Specialist 509.688.0035 509.688.0037 — fax cc: Gordon Curry — Excell Construction Co s j� APPLICANT: DEPARTMENT OF COMMUNITY DEVELOPMENT CURRENT PLANNING ADMINISTRATIVE EXCEPTION APPLICATION AND DETERMINATION MAILING ADDRESS: `,i CITY: �Q d PC('can/ - / �^7y/ /y �/STQA.TE: /W! A (� ZIP:: PHONE: (HOME) f 9 —lob < 7' (WORK) 70_7, -Q4� � � (CELL) ' G 3 D "7 NOTE: IF APPLICANT IS NOT THE OWNER, INCLUDE WRITTEN OWNER AUTHORIZATION FROM THE LEGAL OWNER BELOW LEGAL OWNER: MAILING ADDRE CITY: ATE: ZIP: TAX PARCEL No: .. ci "7 xS�O oZ I �f' �j... — -- .... :.:c_ CCELL .. _— --- �i"REET ADDRESS OF SITE. LEGAL DESCRIPTION: ,Le! T/ &F l l f)/'x .�sl ZONING CLASSIFICATION: It r "! r/ COMPREHENSIVE .TIVE EXPLAIN REASON FOR REQUEST: APPLICABLE SECTION(S) OF ZONING CODE: / 7' -5-0 4 Q2-1OC 3,3 . NOTE: A SITE PLAN AND SUPPORTIVE DOCUMENTS SHALL BE INCLUDED WITH MISAPPLICATION PART II LEGAL OWNER SIGNATURE (Signature of legal owner or representative as authorized by legal owner) I, dY�`` (print name) SWEAR OR AFFIRM THAT THE ABOVE RESPONSES ARE MADE HFULL)' AND TO THE BEST OF MY KNOWLEDGE. I FURTHER SWEAR OR AFFIRM THAT I AM THE OWNER OF RECORD OF THE AREA PROPOSED - —FSR--THE-ABODE IDENT-IFIED-LAND--US- -E-ACT-ION—OR5--T—NO .,A-TT-AC�D - - HEREWITH IS WRITTEN PERMISSION FROM THE OWNER AUTHORIZING MY ACTIONS ON HIS/HER BEHALF. ADDRESS: STATE OF WASHINGTON COUNTY OF SPOKANE - 0 �) (State) NOTARY or Part II= a -- ss: SUBSCRIBED AND SWORN to before me this NOTARY SEAL PHONE: 7 ac-= o c� ZIP: a (Date) day of I l , 20 SNA44. NOTARY SIGNATURE Q �yStON Qom' '9p Notary Public in and for the State ''oft1 Washipgton cd NOTARY � V _ a; _ i Residing at: a PUB.ble� 9�F My appointment expires: OF Wd'SN� PART III (To be completed by the Planning Staff) DATE SUBMITTED: RECEIVED BY: FEE: d Fi LE NO.: DETERMINATION File No: AE-4--oe The Department of Community Development finds that the information provided by the applicant n/d compliance with the City of Spokane Valley Zoning Code and all other development regulations, does not adverse affect on the adjacent properties nor the ub "ds eneral health, safety and welfare. The Department of Community DevelopIn approves denies this "Administrative Exemption" as conditioned below, for the property described in Part I, ursuant t ections 14.506:000 and 14.506.020 of the Zoning Code. This administrative exception is subject to the following conditions of approval: 1) This administrative decision shall apply to the subject property indefinitely and may be transferred to future property owners, heirs or any successor in interest to the property subject to the conditions of approval contained herein. 2) The applicant and property owner shall comply with all requirements and regulations of the Zoning Code. 3) . The applicant shall comply with all applicable development regulations. and standards. . 4) The applicant and property owner shall comply with the following additional conditions: This administrative exception is hereby.appro d this / -7, day of 20e 4o Approved by: Title: Under Section 14.412.041 of the City Zoning Code, any person aggrieved by this administrative determination has the right to appeal this administrative decision to the City of Spokane Valley Hearing Examiner. An appeal must be filed by submitting the appropriate appeal application together with the required fee to the Department of Community Development Current Planning, within fourteen (14) calendar days after the decision is issued. Upon receipt of a complete appeal application, a public hearing will be scheduled. For information or questions, please call (509) 921-1000 Rev 6/03