2003, 01-13 Permit App: 03000245 DuplexProject Number: 03000245
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/13/2003 Page 1 of 3
Project Information:
Permit Use: DUPLEX W/GARAGES - NATURAL GAS Contact: ENGEBRETSON, JOHN
Address: 111 W ROLLAND AVE
C - S - Z: SPOKANE,WA 99218
Setbacks: Front 97 Left 87 Right: 30 Rear: 20 Phone: (509) 953-8808
Group Name:
Project Name:
Site Information:
Plat Key:
Name: District: F
Parcel Number: 45233.0926 Block: 158 Lot:
SiteAddress: 1015 N EVERGREEN RD Owner: Name: ENGEBRETSON, JOHN
VERADALE, WA USA 99037 Address: 111 W ROLLAND AVE
Location:: VER SPOKANE, WA 99218
Zoning: UR -3.5
Water District:
Area: 28,497 Sq Ft
Nbr of Bldgs: 1
Urban Residential 3.5
Hold: El
Width: 177 Depth: 161 Right Of Way (ft): 12
Nbr of Dwellings: 2
Review
Site Plan Review
Released By:
Plan Review
Released By:
Special Reviews
—11:02434 tA/A.12ft
QoJst
Approach / Drainage
ni) 4,VADCA
Septic System Review
VNPI. 17
Operator: CKF Printed By: CKF
Print Date:
1/13/2003
WO,
Project Number: 03000245
Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/13/2003 Page 2 of 3
Landuse/Zoning
Permits:
Contractor: PRECISE MECHANICAL
Address: 1310 S AVALON CT
SPOKANE WA 99216
Const Category: New
Nbr Of Dwellings:
Bldg W x D: x
Req Parking:
Description Gtr
2ND FLOOR R-3
DECK R-3
GARAGE U-1
RESIDENCE R-3
Building Permit
Finn: PRECISE MECHANICAL
Phone: (509) 922-9666
Building Characteristics
Group:
Occupant Load:
Building Sq Ft:
Handicap Parking:
Type Notes
VN
VN
VN
VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: PRECISE MECHANICAL
Address: 1310 S AVALON CT
SPOKANE WA 99216
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
HOOD -TYPE II
Type:
Building Height: Stories:
Sprinklers:
Critical Materials: El
This Application: Total Project:
Sq Ft Valuation Sq Ft Valuation
1,392 $91,872.00 1,392 $91,872.00
200 $1,566.00 200 $1,566.00
792 $9,504.00 792 $9,504.00
1,376 $90,816.00 1,376 $90,816.00
Totals: 3,760 $193,758.00 3,760 $193,758.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Fee Amount
$1,365.00
$4.50
$300.30
Permit Total Fees: $1,669.80
Mechanical Permit
Units
2
2
4
6
2
2
Operator: CKF Printed By: CKF
Firm: PRECISE MECHANICAL
Phone: (509) 922-9666
Unit Desc
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
Fee Amount
$20.00
$24.00
$4.00
$60.00
$20.00
$20.00
$148.00
1/13/2003
Project Number: 03000245 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/13/2003
Contractor: PRECISE MECHANICAL
Address: 1310 S AVALON CT
SPOKANE WA 99216
Item Description
TOILETSBIDETS
SINKS
SHOWERS
DISH WASHERS
CLOTHES WASHER
WATER USING DEVICES
Plumbing Permit
Units
6
8
4
2
2
2
Permit Type Fee Amount
Building Permit $1,669.80
Mechanical Permit $148.00
Plumbing Permit $144.00
Page 3 of 3
Firm: PRECISE MECHANICAL
Phone: (509) 922-9666
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Invoice Amount
$1,669.80
$148.00
$144.00
$1,961.80 $1,961.80
Fee Amount
$36.00
$48.00
$24.00
$12.00
$12.00
$12.00
Amount Paid
$0.00
$0.00
$0.00
$144.00
Amount Owing
$1,669.80
$148.00
$144.00
$0.00
$1,961.80
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: CKF Printed By: CKF
Print Date: 1/13/2003
,' Aber: 03000245 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/13/2003 Page 1 of 3
•
Project Information:
Permit Use DUPLEX W/GARAGES - NATURAL GAS
Setbacks: Front 97 Left: 87 Right: 30 Rear: 20
Site Information:
Plat Key Name
Parcel Number: 45233.0926 Block
SiteAddress: 1015 EVERGREEN RD
VERADALE, WA USA 99037
Location:: VER
Contact: ENGEBIETSON, JOHN
Address: 111 W ROLLAND AVE
C - S - Z: SPOKANE, WA 99218
Phone: (509) 953-8808
Group Name:
Project Name.
158 Lot:
Zoning: UR -3.5
Watcr District.
Urban Residential 3.5
District: F
Owner: Name: ENGEBRETSON, JOHN
Address: 111 W ROLLAND AVE
SPOKANE, WA 99218
Hold: Li
Area 28,497 Sq Ft Width: 177 Depth: 161 Right Of Way (ft): 12
Nbr of Bldgs: 1 Nbr of Dwellings: 2
Review Information:
Review
Site Plan Review
Plan Review
Special Reviews
JLC,
Approach / Drainage
Y1 D
Released By:
Released By:
Coes
Septic System Review
/4-7,4v2./
for
if-FNAl7
lhrstem designed
bedrooms onhr.
Operator: CKF
ZeZtf
e system des.
rooms, or
OCCUPANCY
installation has
Printed By: CKF
Released By.
gallons
=.f LOWED until syst
SRHD approval.
Print Date:
1/13/2003
I 1
SPOKANE COUP
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 \.FEST BROADWAY AVENUE
SPOKANE, \V'!\ 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: tom r ,t D' e> i / ,7 e 1D.�% r„ �
Assessor's Tax Parcel Number(s): L (1-5P3 3 . O I Zfo
Legal Description:
Project Description: .JA) pi
f' Building Permit
Cl Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
Department Use Only
Water District/Purveyor:
Sewer District/Purveyor
Road width
Setbacks
Front Rear.
School District:
Fire District:
Zoning
Right.
OWNER/APPLICANT INFORMATION
Indicate n -fair should be eonlucled repurdina ibitDroied
f 4 X /77 - 2 1q
❑ (honer:jj,,..�� Phone ,500 -)551`88
� 1CNr"/ C ✓i� N' br-Zvi- -\ Fax:
El Applicant:
Phone:
Fax:
Mailing Address ✓
i I ! !,.t.) (20/11.14 C1 �— VP
Mailing Address:
Dimensions
t
(: tv, State, Zip
boil_ . S'S,..1g
City, State, Zip
Finished basement sq. ft.
_5&t-AJe
7 _
❑ Contractor Phone 5 /. '- Jr (_ f 7-i'3i')
ri'rec 6e l/V& S_t�U�NA1CLlI Fax `5Q' 5'.'026" --O)1
❑ Architect/Engineer
Phone
las
Mailing address
t -L 2 5 .P. ,e q LP,yrt (,:a
Mailing address
I leat sour e (electric, gas, etc.)
0, elm
City, State Zip /
a(este. oJ--, . of 90 3 7
City, State Zip
WA State Contractor license #
Contact name:
PROTECT INFORMATION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
t
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft. A"A
Cost of project
)^
til !t- S X00
I leat sour e (electric, gas, etc.)
0, elm
Manufactured Home
Sign
width:
Length:
What is the square footage of the sign
face?
1 low high is the sign?
Year:
Make:
# of signs
Area of existing signs
Fireworks display
Are critical or hazardous materials used or stored on site?
❑ Ycs l3-. No
Address
Proposed use
Relocation
Fire Safety
I..irm Name
What is the current use of this property?
0;4 /
Previous address
Will the site be served by a septic systern? L3 Ycs ❑ No
Paint booth
Fire Sprinkler
Tent
Fire Alarm
Fireworks display
Are critical or hazardous materials used or stored on site?
❑ Ycs l3-. No
Address
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
I..irm Name
What is the current use of this property?
0;4 /
Phone
Will the site be served by a septic systern? L3 Ycs ❑ No
Plans Isaminer
Phone
Inspectors:
Is there evidence of till or excavation 00 the property?
❑ Ycs 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( ..............0/0 ❑ Ycs ❑' No
Are critical or hazardous materials used or stored on site?
❑ Ycs l3-. No
Address
Inspector
Phone
❑ Concrete
❑ Welding
❑ Bolting
❑ Reinforcement
Address
DITIONAL SITE INFORMATION
Are there strictures on the property? ❑ Ycs 'No
If yes, ident j, 011 Site plan
What is the current property size?
(square feet or acres) 2!3 yam
Is any part of the property within 250 feet of a shorclita*i
If yes, ide/dlt' on site plan ❑ Ycs ' No
What is the current use of this property?
0;4 /
Is your property in a designated wildlife habitat arca? _ -
❑ Don't know ❑ Ycs 0 --No
Will the site be served by a septic systern? L3 Ycs ❑ No
Is any part of the property within a 100 yr flood plain?
If yes. /de/It(IY 0/1 site pla/1If
❑ \laybc ❑ Don't know ❑ Yes C3`No
Are or will there be wells located 00 the property?
yes, ide/Itl[j' 0/1 the site plan ❑ Yes [ _No
Are there any wetlands, streams or ponds within 200 feet of the property?
If per, identify on site plan ❑ Ycs Cr No
Is there evidence of till or excavation 00 the property?
❑ Ycs 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( ..............0/0 ❑ Ycs ❑' No
Are critical or hazardous materials used or stored on site?
❑ Ycs l3-. No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
❑ Yes
❑ No
Is public sewer available to the site? ❑ Ycs ❑ No
Is the property inside the ASA?
❑ Yes
❑Ycs
❑ No
0 N
Is public water available to the site? ❑ Yes ❑ No
Is the property inside the PSSA?
❑ Ycs
❑ No
Is the property located within 1000 feet of a Natural Resource Area?
❑ Yes ❑ No
Date Recencd:
Staff Rcpresentatice:
METHOD OF PAYMENT
VISA
0 c.\sl I 0 CI n?a: 0 MOM 0
O
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
B1NKC 1R1) NU11Bl?R:
1?\PIRI?S:
1UTI IORI'/,I?1) SI( N:VI'URE:
SUBTOTAL
TOTAL FEE
MINIMUM PERMIT FEE IS $35.00 PLEASE
MAKE CHECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER
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