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2002, 07-22 Permit App: 02006154 AdditionProject Number: 02006154 Inv: 1 a Application THIS IS NOTA PERMIT Penalties will be assessed for commencing work without a permit Date: 7/22/02 Page 1 of 3 Project Information: Permit Use: FAMILY ROOM ADDITION W/BATHROOM Setbacks: Front NA Left: 30+ Right: 10 Rear: 30+ Site Information: Plat Key: 000000 Name: UNKNOWN Parcel Number: 45092.0722 Block: Contact: KEVIN SMITH INC Address: 1307 E BLACKWOOD LN C - S - Z: SPOKANE WA 99223 Phone: (509) 448-6043 Group Name: Project Name: Lot: District: H SiteAddress: 10808 E FAIRVIEW AVE Owner: Name: SKILLINGSTAD, DONALD & BET Spokane, WA USA 99206 Address: 10804 E FAIRVIEW AVE Location:: SPO SPOKANE, WA 99206-2601 Zoning: UR 3.5 Water District: Hold: ❑ Area: 20,568 Sq Ft Width: 137 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 2 Nbr of Dwellings: 0 Review Information: Review Site Plan Review Plan Review Septic System Review Permits: Released By: 4 Released By: Released By: / "J Operator: CKF Printed By: CKF Print Date: 7/22/02 Project Number: 02006154 Inv: 1 Application THIS I$ NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/22/02 Page 2 of 3 Building Permit Contractor: KEVIN SMITH INC Firm: KEVIN SMITH INC Address: 1307 E BLACKWOOD LN Phone: (509) 448-6043 SPOKANE, WA 99223 Building Characteristics Const Category: Addition Group: R-3 Type: VN Nbr Of Dwellings: Occupant Load: Building Height: 20 Stories: 1 Bldg W x D: 22 x 34 Building Sq Ft: 748 Sprinklers: ❑ Req Parking: Handicap Parking: Critical Materials: ❑ This Application: Total Project: Description Grp Type Notes Su Ft Valuation Su Ft Valuation RES ADD R-3 VN 748 $49,368.00 748 $49,368.00 Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Totals: 748 $49,368.00 748 $49,368.00 Units Unit Desc Fee Amount 1 Y OR BLANK $577.00 1 Y OR BLANK $4.50 1 Y OR BLANK $126.94 Permit Total Fees: $708.44 Mechanical Permit Contractor: KEVIN SMITH INC Firm: KEVIN SMITH INC Address: 1307 E BLACKWOOD LN Phone: (509) 448-6043 SPOKANE, WA 99223 Item Description VENTILATING FANS MINIMUM FEE ADJUSTMENT Units Unit Desc 1 NUMBER OF 1 Select Fee Amount $10.00 525.00 Permit Total Fees: $35.00 Plumbing Permit Contractor: J & J PLUMBING & HEATING Firm: J & J PLUMBING & HEATING Address: 3515 N BEIGE Phone: (509) 000-0000 SPOKANE WA 99000 Item Description Units Unit Desc Fee Amount TOILETSBIDETS 1 NUMBER OF $6.00 SINKS 2 NUMBER OF $12.00 SHOWERS 1 NUMBER OF 56.00 WATER PIPING - DEIN 1 NUMBER OF $6.00 MINIMUM FEE ADJUSTMENT 1 Select $5.00 Operator: CKF Printed By: CKF Permit Total Fees: $35.00 Print Date: 7/22/02 Project Number: 02006154 Inv: 1 Application THIS IS NOTA PERMIT Penalties will be assessed for commencing work without a permit Date: 7/22/02 Page 3 of 3 Payment Summary: Permit Type Building Permit Mechanical Permit Plumbing Permit Fee Amount $708.44 $35.00 $35.00 $778.44 Invoice Amount $708.44 $35.00 $35.00 $778.44 Amount Paid Amount Owing $0.00 $708.44 $0.00 $35.00 $0.00 $35.00 $0.00 $778.44 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 coutrued 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: 7/22/02 Manufactured Home Sign Width: Length: I` What is the square footage of the sign face? 11ow high is the sign? Year: �1 Ike ' # of signs Area of existing signs -- 'Tent Firc i f Fireworks display Relocation Fire Safety Firm Name Phone Plans I Naminer Previous address inspectors: Paint booth Fire Sprinkler Is any part of the property within a 100 yr flood plain? I_ f yes, identifi, on site plant ❑ Maybe ❑ Don't know ❑ Yes No -- 'Tent Firc i f Fireworks display �'/ ❑ Concrete �O�C'elding ❑ Bolting ❑ Reinforcement Addres% Proposed use ------ Value Special Inspections Required? Non -Residential Energy Code Compliance? Firm Name Phone Plans I Naminer Phone inspectors: Will the site be served by a septic system? ❑ Yes Address Is any part of the property within a 100 yr flood plain? I_ f yes, identifi, on site plant ❑ Maybe ❑ Don't know ❑ Yes No Are or will there be wells located on the property? I f hes, ident/' on the site plan ❑ Yes i/ Inspector Phone �'/ ❑ Concrete �O�C'elding ❑ Bolting ❑ Reinforcement Addres% ADDITIONAL SITE INFORMATION Are there structures on the property? i'es ❑ No Ifyes, identifi, on site plain What is the current property size? (square feet or acres) Is the property inside the ASA? ❑ Yes ❑ No ❑Yes 0 N Is any part of the property within 250 feet of a sh? I. Eyes, identifi, on site plan ❑ Yes o= What is the current use of this pro erty? ', , - /`,i; 7"/ /1-- Is your property in a designated wildlife habitat area? ❑ Don't know ❑ Yes N o Will the site be served by a septic system? ❑ Yes N Is any part of the property within a 100 yr flood plain? I_ f yes, identifi, on site plant ❑ Maybe ❑ Don't know ❑ Yes No Are or will there be wells located on the property? I f hes, ident/' on the site plan ❑ Yes 1S o Are there any wetlands, streams or ponds within NO fset of the property? yes, identi on site plan ❑ Yes No Is there evidence of fill or excavation on the property? ❑ Yes �yN� H'o Are there slopes greater than 30°% on the property? (30 t In 100 ft) ( °%) ❑ Yes ,o Are critical or hazardous materials used or stored on sit? ❑ Yes , No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? ❑Yes 0 N Is public sewer available to the site? ❑ Yes ❑ No Is the property inside the ASA? ❑ Yes ❑ No ❑Yes 0 N Is public water available to the site? ❑ Yes ❑ No Is the property inside the PSSA? ❑ Yes ❑ No Is the property located within 1000 feet of a Natural Resource Area? ❑ Yes ❑ No Date Rccc,vcd: Staff Rcprescntatirc: METHOD OF PAYMENT VISA ❑ cAsI 1 ❑ CHECK ❑MUM❑ . 0 FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD I):\'1'I EXPIRES: B.\NKCAR1) NUMBER: 111'l1 I0R1Z1.1) SIGN A'1'URI?: SUBTOTAL TOTAL FEE MINIMUM PERMIT FEE IS $35.17 PLEASE MAKE CI IECKS PAYABLE 10 SPOKANE COUNTY PERMrr (:ENTER Z Jo Z abed o•• � 86/9Z/I►U :3w(1 U(>!luaIrid 1 t5L(/I(�86=�aqumN loafoJd I A ORFS 11' 12. �qs {c •-'e r,� 'Is qe 13' i .,, ���S g e� �� ti +d(K� • ' x(10 wa1". i ptalr ' �°{ `e vt ` c_ 1� :t\'t14�ib.. t .�., J ' 11�e�g��r 1e :;;;_iii_ � IS aoa�e$ °� Idro if ea •, .�� �' ._ i 16' —�aie ` 1 f -- far tce�� --t- i 17' • FT4iRV/EW AVE.