2005, 05-09 Permit App: 05001473 ResidenceMHT 51 eueop 1D,47 rK
Prject Number. 05001473 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
I U 4 I • r.JG
Date: 05/09/2005 Page 1 of 4
Project Information: ;
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Permit Use: NEW RESIDENCE W/ATTACHED GARAGE - Contact CREATIVE HOME & GARDEN DESIGN
NATURAL GAS Address: 6413 E JOSEPH LN
C - S - Z: SPOKANE, WA 99217
Setbacks: Front 20 Left 20 Right: 5 Rear 84 Phone: (509) 991-9129
Group Name:
Project Name: ROW
Site Information:
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Plat Key: 001641 Name: M1RA.BEAU RANCH ADD District: Nor.
Parcel Number: 4509L0236
Block: 2 Lot: 8
SiteAddress: 12023 E FAIRVIEW AVE Owner: Name: HILL, TIMOTHY E
Address: 1120 S WALNUT RD
Location:: CSV SPOKANE VALLEY, WA 99206
Zoning: UR -3.5 Urban Residential 3.5
Water Distiet: Hold: 0
Area: 13,580 Sq Ft Width 0 Depth: 0 Right Of Way (ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:=7"...,,,...74,...%Tarl...^,.=.5.,:=EZ]=Z:^1.i==.121=1=1,:3:
Review
Site Plan Review
Released Bykg
Plan Review
Released By:
Approach / Drainage
Rcleased ..34444
Septic System Review
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OCCUPANCY NOT ALL
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Permits.
•
Operator. K_C Printed By: K_C Print Date: 05/09/2005
•
SPOKANE
H
REGIONAL
LT H
D !STRICT
APPLICATION FOR ON-SITE
Client Copy
Environmental Health Division
1101 West College Avenue
Spokane, WA 99201-2095
SEWAGE SYSTEM
Application No. 05-7267
Area Tract: M
Date of Application: 05/13/2005
Daily Inspection Announcement: 324-1581
Inspection Call In: 324-1560
Site Address/Legal Description of Property/Town: Parcel #:
12023 E FAIRVIEW AVE SPOKANE WA 45091.0236
Legal Owner of Property:
TIMOTHY E HILL
SPO NE REGIONAL HEALTH DIST.
1101 WEST COLLEGE
SPOKANE, WA 99201
(509) 324-1560
REG-RECEIPT:03-0036206 C:May 13 2005
CASHIER ID:051 11:38 am A:May 13 2005
5309 LW -APPLICATION FOR $45.00
5321 LW -PERMIT -INSTALL $180.00
TOTAL DUE
RECEIVED FROM:
TIMOTHY E HILL
$225.00
CHECK: $225.00
TOTAL TENDERED $225.00
CHANGE DUE $0.00
****************************************
SPOKANE REGIONAL HEALTH DISTRICT OFFERS
MANY SERVICES, IF YOU NEED ASSISTANCE
FINDING THE CORRECT PROGRAM OR PHONE
NUMBER CALL OUR MAIN RECEPTIONIST AT
(509) 324-1500 FOR MORE INFORMATION.
****************************************
Lot/Biock/Subdivison
L8 B2
MIRABEAU RANCH ADD
Owner Address:
1120 S WALNUT ROAD
SPOKANE, WA 99206
Property Size:
Owner Phone:
(509) 991-9129
No. of Bedrooms: 3 Additional bedrooms wiil require a larger system
Septic Tank
IRVIN
No. 1 Size: 1000
Property Located In: PSSA/Inside ASA U
Mail Correspondence to:
1120 S WALNUT ROAD
SPOKANE WA 99206
native:
You may use this Call -In Dates section to track when you
called our office for inspections.
Project Number: 05001473 Inv: 1
Application
Date: 05/09/2005 Page 1 of 4
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE -
NATURAL GAS
Setbacks: Front 20 Left: 20 Right: 5 Rear: 84
Site Information:
Plat Key: 001641 Name: MIRABEAU RANCH ADD
Contact: CREATIVE HOME & GARDEN DESIGN
Address: 6413 E JOSEPH LN
C - S - Z: SPOKANE, WA 99217
Phone: (509) 991-9129
Group Name:
Project Name: ROW
District: Nort
Parcel Number: 45091.0236 Block: 2
SiteAddress: 12023 E FAIRVIEW AVE
Location:: CSV
Zoning: UR -3.5
Water District:
Area: 13,580 Sq Ft
Urban Residential 3.5
Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Lot: 8
Owner: Name: HILL, TIMOTHY E
Address: 1120 S WALNUT RD
SPOKANE VALLEY, WA 99206
Hold: ❑
Depth: 0 Right Of Way (ft): 50
Review
Site Plan Review
Released By:�
Plan Review
Released By: (,
F r
)t�l:��
Approach / Drainage
l
Released By:
Aseptic System Review
Permits:
Released By:
I
Operator: K_C Printed By: K_C Print Date: 05/09/2005
Projeet Number: 05001473 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/09/2005 Page 2 of 4
Approach
Contractor: CREATIVE HOME GARDEN Firm: CREATIVE HOME & GARDEN DE
Address: 6413 E JOSEPH LN Phone: (509) 487-2362
SPOKANE, WA 99217
Item Description
APPROACH INSPECTION
CONST IN ROW - APPROACH
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Building Permit
Fee Amount
$25.00
$25.00
$50.00
Contractor: CREATIVE HOME GARDEN Firm: CREATIVE HOME & GARDEN DE
Address: 6413 E JOSEPH LN
SPOKANE, WA 99217
Group: R-3 Type: VB
Total Area 3244
Building Height 16
Stories 1
Dwelling Units 1
Phone: (509) 487-2362
Building Characteristics
This Application: Total Project:
Description Grp llym Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT U R-3 VB 1,622 $24,330.00 1,622 $24,330.00
COV DECK R-3 VB 120 $1,800.00 120 $1,800.00
GARAGE U-1 VB 413 $7,847.00 413 $7,847.00
RESIDENCE R-3 VB 1,622 $121,130.96 1,622 $121,130.96
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Totals: 3,777 $155,107.96 3,777 $155,107.96
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Fee Amount
$1,307.35
$4.50
$522.94
Permit Total Fees: $1,834.79
Operator: K_C Printed By: K_C Print Date: 05/09/2005
Project Number: 05001473 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/09/2005 Page 3 of 4
Contractor: CREATIVE HOME GARDEN
Address: 6413 E JOSEPH LN
SPOKANE, WA 99217
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
GAS LOG OR GAS INSERT
HOOD -TYPE II
Contractor: CREATIVE HOME GARDEN
Address: 6413 E JOSEPH LN
SPOKANE, WA 99217
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
CLOTHES WASHER
WATER USING DEVICES
Mechanical Permit
Units
1
1
3
4
1
1
1
Units
2
3
1
2
1
1
2
Operator: K_C Printed By: K_C
Firm: CREATIVE HOME & GARDEN DE
Phone: (509) 487-2362
Unit Desc
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Fee Amount
$10.00
$12.00
$3.00
$40.00
$10.00
$10.00
$10.00
Permit Total Fees: $95.00
Plumbing Permit
Firm: CREATIVE HOME & GARDEN DE
Phone: (509) 487-2362
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Fee Amount
$12.00
$18.00
$6.00
$12.00
$6.00
$6.00
$12.00
$72.00
Print Date: 05/09/2005
Project Number: 05001473 Inv: 1
•
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/09/2005 Page 4 of 4
Payment Summary:
Permit Type
Approach
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$50.00
$1,834.79
$95.00
$72.00
Invoice Amount
$50.00
$1,834.79
$95.00
$72.00
$2,051.79 $2,051.79
Amount Paid
$0.00
$0.00
$0.00
$0.00
Amount Owing
$50.00
$1,834.79
$95.00
$72.00
$0.00 $2,051.79
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: K_C Printed By: K_C Print Date: 05/09/2005
Spokane
40V -alley
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) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address:
!1.0L5 r
l-ui✓�Vi`Cw AG!•
Assessor's Tax Parcel Number(s):
Legal Description:
8
o�3C
PERMIT DESCRIPTION:
uilding Permit
n Relocation
n
n
8z Jli I u R6, t,/
n Change in Use
Tenant Improvement
Grading n Manufactured Home
Fire Safety (n Other
OWNER/APPLICANT INFORMATION
Owner: �,'�,,,� e k1=• H, 11
Phone: 't q -dT 39 'Fax:
Address: So ll) p 1tiJh K t Rd.
c
Cr 1 State���Zip ode I CC 1' �� - -� "\t
Contractor:��f�S [n
Phone: Fax:
Address:
City
State
WA State Contractor License #:
Zip Code
App:
ss:
City
OState Zip Code
Archi
Phone: Fax:
Address:
City
Contact:
State
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: /� 1
DIMENSIONS: zG,` �� 1 Z t'
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2Nu FLOOR SQ. FTG: �
UNFIN BASEMENT S FTG:
FINISHED BASEMENT SFTG:
GARAGE SQ. FTG: . 913
DECK/COV. PATIO SQ.OFTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:.
HEAT SOURCE: F AC
# OF BEDROOMS: 3
TOTAL H A HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
1 et 04_Cqn
30% SLOPES ON FOPERTY:
SEWER OR ON-SITT SEPTIC
SYSTEM? C.0 -1-;t
L MANUFACTURED HOME
Width:
Manufacturer:
Length: Year: Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation:
Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector: Phone: ,Fax:
Address:
z
p
City
State
Zip
SPECIAL INSPECTIONS
n BOLTING LJ CONCRETE
Firm Name:
n REINFORCEMENT
Phone:
Inspector(s):
Fax:
❑ 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) This 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 to the
Print Name T, w, 0 /
Signature t�
r.. - y owner.
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
n Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
1
vie
50
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COMMENTS
REVIEWED BY
This site plan is being submitted for the purpose of
obtaining a building permit and is a true and correct
representation of the proposal. All known property
lines/dimensions. curb lines. structures and easements
have been identified. Also indicated are wetlands,
/ . or • . • • /A .4 I :
Signed. --.00( Aze.,e,-/
Date:
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