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2005, 12-09 Permit App: 05004624 Finish BasementProject Number: 05004624 Inv: 1 .4 Application Date: 12/09/2005 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: FINISH BASEMENT Setbacks: Front Site Information: Left: Right: Rear: Contact: ROHM, BRIAN Address: 19411 E FLAT ROCK RIVER LANE C - S - Z: SPOKANE VALLEY, WA 99016 Phone: (509) 893-2980 Group Name: Project Name: Plat Key: 005859 Name: RIVERWALK 08TH ADD PUD District: G Parcel Number: 55083.5106 Block: 2 SiteAddress: 19411 E FLAT ROCK RIVER Location:: CSV Zoning: UR -7 Water District: Area: 1,977.00 Acres Urban Residential -7 Lot: 6 Owner: Name: ROHM, BRIAN Address: 19411 E FLAT ROCK RIVER LANE SPOKANE VALLEY, WA 99016 Hold: ❑ Width: 82 Depth: 109 Right Of Way (ft): 45 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Plan Review Released By: Sewer Review Permits: Originally Released: 12/09/2005 By: TMELBOU Released By: Originally Released: 12/09/2005 By: cjjanssen Operator: CJJ Printed By: CJJ Print Date: 12/09/2005 Project Number: 05004624 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 12/09/2005 Page 2 of 2 Building Permit Contractor: OWNER Firm: OWNER Phone: (000) 000-0000 This Application: Total Project: Description Grp Type Notes Su Ft Valuation Sq Ft Valuation BASEMENT R R-3 VB FINISH 0 $10,000.00 0 $10,000.00 BASEMENT Item Description RESIDENTIAL PERMIT FEE STATE SURCHARGE RESIDENTIAL PLAN REVIEW Totals: 0 $10,000.00 0 $10,000.00 Units Unit Desc 1 SELECT 1 SELECT 1 SELECT Permit Total Fees: Plumbing Permit Fee Amount $181.25 $4.50 $72.50 $258.25 Contractor: OWNER Firm: OWNER Phone: (000) 000-0000 Item Description TOILETS/BIDETS SINKS SHOWERS Notes: Units Unit Desc 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF Permit Total Fees: Fee Amount $6.00 $6.00 $6.00 $18.00 ALL PERMIT APPLICATIONS IN MISSION MEADOWS MHP MUST HAVE PLANNING DIVISION REVIEW BY MICKI HARNOIS OR GREG MCCORRMICK Payment Summary Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $258.25 $258.25 $0.00 $258.25 Plumbing Permit $18.00 $18.00 $0.00 $18.00 $276.25 $276.25 $0.00 $276.25 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: CJJ Printed By: CJJ Print Date: 12/09/2005